Hemodialysis Impact on QTc Interval: An Arrhythmia Precursor

Abstract

Background: Hemodialysis has been implicated as being a trigger for arrhythmias. There is an increase in arrhythmia risk following the long inter-dialytic period. This data suggest that applying the same parameters of dialysis without daily electrolytes tests may trigger fatal arrhythmias and could be a modifiable cause of sudden cardiac death. Aim: Early detection of arrhythmia to correct its underlying cause and prevent the occurrence of sudden cardiac death. Subjects and Methods: Observational study that included 60 maintenance hemodialysis (HD) patients to assess the prevalence of QTc prolongation before, during, and after HD in patients who are on maintenance HD in the out/inpatient departments of Suez Canal University. Results: High prevalence of QTc prolongation among the studied population, representing 73.3%. The most common primary disease was glomerulonephritis disease (43.2%) (p=0.006). Moreover, it was found that patients with prolonged QTc was significantly associated with longer HD duration (p=0.020), HD length equal or more than 4 hours (p=0.004), intradialytic hypotension (p=0.029), and non-high flow dialyser (p=0.016). Additionally, patients with prolongation of QTc interval had significant higher pre-dialysis K+ & Na+ levels (p < 0.001, 0.002 respectively). Conclusion: QTc prolongation is common in patients on regular HD. Different factors are associated with occurrence of arrhythmias in HD patients.