The disparate effect of hemodialysis and hemodiafiltration on T-wave-peak-to-end interval (Tpe) and Tpe/QT ratio of the surface electrocardiogram

Aim: The prolongation of T-wave-peak-to-end interval (Tpe) and arrhythmogenic index (AIX) could predict arrhythmias. Developing of ventricular arrhythmias is increased during hemodialysis (HD), but the effects of hemodiafiltration (HDF) on ventricular repolarization have not been elucidated yet. Methods: Thirty patients was investigated while they were receiving hemodiafiltration over a period of three months then the same group of patients was evaluated during treatment with hemodialysis for at least another three months. Ionic parameters, surface electrocardiograms (ECG), echocardiography, Holter ECGs were performed. Results: T-wave-peak-to-end interval and arrhythmogenic index significantly increased at the 240th minute of hemodialysis while did not change during hemodiafiltration. No malignant ventricular arrhythmias occurred, but number of ventricular premature beats was significantly higher during hemodialysis as compared to those during hemodiafiltration. Regarding hemodialysis a significant relationship was observed between the ratio of ventricular premature beats and arrhythmogenic index. Left ventricular mass index, septal-, posterior wall, inferior vena cava, left atrial diameters showed a positive correlation with T-wave-peakto-end interval only in the case of hemodialysis. A negative correlation occurred between the left ventricular ejection fraction, T-wave-peak-to-end interval and arrhythmogenic index, moreover between serum sodium and T-wave-peak-to-end interval, arrhythmogenic index during hemodialysis. Conclusions: Our results suggest that hemodialysis has unfavourable effect on the studied ECG parameters compared to hemodiafiltration. Correspondence to: Zoltan Szabo, Institute of Medicine University of Debrecen Clinical Centre, Faculty of Medicine, Nagyerdei krt. 98. 4032 Debrecen, Hungary, Tel: (36)-52-413 653; E-mail: [email protected]