title: Alterations of atrial electrophysiology related to hemodialysis session: insights from a multiscale computer model.
abstract: BACKGROUND
  The prevalence of atrial fibrillation is increased in patients with end-stage renal disease. Previous studies suggested that extracellular electrolyte alterations caused by hemodialysis (HD) therapy could be proarrhythmic.
  
  
  METHODS
  Multiscale models were used for a consequent analysis of the effects of extracellular ion concentration changes on atrial electrophysiology. Simulations were based on measured electrolyte concentrations from patients with end-stage renal disease.
  
  
  RESULTS
  Simulated conduction velocity and effective refractory period are decreased at the end of an HD session, with potassium having the strongest influence. P-wave is prolonged in patients undergoing HD therapy in the simulation as in measurements.
  
  
  CONCLUSIONS
  Electrolyte concentration alterations impact atrial electrophysiology from the action potential level to the P-wave and can be proarrhythmic, especially because of induced hypokalemia. Analysis of blood electrolytes enables patient-specific electrophysiology modeling. We are providing a tool to investigate atrial arrhythmias associated with HD therapy, which, in the future, can be used to prevent such complications.
authors.affiliation: Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany. publications@ibt.uni-karlsruhe.de
authors.forename: Martin Wolfgang
authors.initials: MW
authors.lastname: Krueger
authors.forename: Stefano
authors.initials: S
authors.lastname: Severi
authors.forename: Kawal
authors.initials: K
authors.lastname: Rhode
authors.forename: Simonetta
authors.initials: S
authors.lastname: Genovesi
authors.forename: Frank Michael
authors.initials: FM
authors.lastname: Weber
authors.forename: Antonio
authors.initials: A
authors.lastname: Vincenti
authors.forename: Paolo
authors.initials: P
authors.lastname: Fabbrini
authors.forename: Gunnar
authors.initials: G
authors.lastname: Seemann
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.forename: Olaf
authors.initials: O
authors.lastname: Dössel
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000209:etiology* / Q000503:physiopathology*; D003198:Computer Simulation; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D006435:Renal Dialysis / Q000009:adverse effects*; D014882:Water-Electrolyte Balance; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000503:physiopathology*