title: Effects of hemodialysis on ventricular activation time in children with end-stage renal disease.
abstract: Patients with end-stage renal disease are affected by cardiovascular complications, including disturbances of the heart intraventricular conduction. Body surface potential mapping is a non-invasive electrocardiographic detection method of initial disturbances in heart activation propagation. A goal of the study was to analyze the effects of single hemodialysis (HD) session on ventricular activation time (VAT) maps obtained from hemodialyzed children. The study group consisted of 13 hemodialyzed children (age: 6-18 years). The control group is composed of 26 healthy subjects. In each HD patient, 12-lead electrocardiogram and echocardiography examinations were performed. Isochrone heart maps, reflecting body surface distribution of VAT isolines, were recorded from an 87-electrode HPM-7100 system for body surface potential mapping, before (group B) and after HD session (group A). The distribution of isochrones and VAT values, as recorded in the HD patients, differed significantly from the reference VAT map for controls. The highest VAT maximal value was noted in group B (Me: 110 vs. 62 ms in the control group; P < 0.001), becoming significantly lower after HD session (Me: 98 ms for group A vs. 110 ms for group B; P < 0.001). Ventricular activation time maps, recorded before HD session, showed significant VAT delays with isochrone arrangement specific for the left bundle branch block. After HD session, VAT maps presented significant changes, suggesting a normalization process. Ventricular activation time maps in children with end-stage renal disease exhibited disturbances of intraventricular conduction within the left bundle branch block, undetectable on standard electrocardiogram. A single HD session resulted in VAT map improvement related to overall HD treatment duration.
authors.affiliation: Department of Pathophysiology, Wrocław Medical University, Wrocław, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Laszki-Szcząchor
authors.forename: Dorota
authors.initials: D
authors.lastname: Polak-Jonkisz
authors.forename: Danuta
authors.initials: D
authors.lastname: Zwolińska
authors.forename: Irena
authors.initials: I
authors.lastname: Makulska
authors.forename: Leopold
authors.initials: L
authors.lastname: Rehan
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Sobieszczańska
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000150:complications*
keywords: BSPM; Children; ESRD; VAT maps; hemodialysis; left bundle branch block