title: Visual three-dimensional representation of beat-to-beat electrocardiogram traces during hemodiafiltration.
abstract: This study evaluated the usefulness of the three-dimensional representation of electrocardiogram traces (3DECG) to reveal acute and gradual changes during a full session of hemodiafiltration (HDF) in end-stage renal disease (ESRD) patients. Fifteen ESRD patients were included (six men, nine women, age 46 ± 19 years old). Serum electrolytes, blood pressure, heart rate, and blood urea nitrogen (BUN) were measured before and after HDF. Continuous electrocardiograms (ECGs) obtained by Holter monitoring during HDF were used to produce the 3DECG. Several major disturbances were identified by 3DECG images: increase in QRS amplitude (47%), decrease in T-wave amplitude (33%), increase in heart rate (33%), and occurrence of arrhythmia (53%). Different arrhythmia types were often concurrent and included isolated supraventricular premature beats (N = 5), atrial fibrillation or atrial bigeminy (N = 2), and isolated premature ventricular beats (N = 6). Patients with decrease in T-wave amplitude had higher potassium and BUN (both before HDF and total removal) than those without decrease in T-wave amplitude (P < 0.05). Concurrent acute and gradual ECG changes during HDF are identified by the 3DECG, which could be useful as a preventive and prognostic method.
authors.affiliation: Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan, Mexico, DF Mexico.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Rodriguez-Fernandez
authors.forename: Oscar
authors.initials: O
authors.lastname: Infante
authors.forename: Héctor
authors.initials: H
authors.lastname: Perez-Grovas
authors.forename: Erika
authors.initials: E
authors.lastname: Hernandez
authors.forename: Patricia
authors.initials: P
authors.lastname: Ruiz-Palacios
authors.forename: Martha
authors.initials: M
authors.lastname: Franco
authors.forename: Claudia
authors.initials: C
authors.lastname: Lerma
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods*; D004573:Electrolytes / Q000032:analysis; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D004573:Electrolytes