Abstract
Twenty-four hours ambulatory electrocardiographic study was performed in 89 patients on maintenance hemodialysis. Electrocardiographic monitoring revealed supraventricular premature contraction (SVPC) in 81 patients (91%), ventricular premature contraction (VPC) in 83 patients (93.3%), atrioventricular block (A-V block) in 19 patients, sick sinus syndrome (SSS) in 6 patients, and ventricular tachycardia (VT) in 8 patients. The patients were classified into three groups according to the numbers of recorded arrhythmias, namely the normal, sporadic, or frequent group. In patients with frequent SVPC, the age was significantly older and the left atrial dimmension were significantly enlarged. In patients with frequent VPC, the ejection fraction was significantly decreased, and the left ventricular dimension was significantly enlarged. Patients with VT had a higher incidence of complication by cardiovascular disease and diabetes mellitus. The administration of antiarrhythmic agents in 25 patients with VPC decreased the frequency of VPC in 9 patients (36%), had no effect or worsened in 16 patients (64%). Two patients classified as worsened progressed to arrhythmogenic death. In patients with worsened group, the ejection fraction was significantly decreased, and the left ventricular dimension was significantly enlarged. These results lead us to conclude that arrhythmias in patients on maintenance hemodialysis are an important indication to investigate underlined cardiovascular disease, impaired cardiac function, and left ventricular dilatation.
