Background: The prevalence of atrial fibrillation is increased in patients with end-stage renal disease. Previous studies suggested that extracellular electrolyte alterations caused by hemodialysis (HD) therapy could be proarrhythmic. Methods: Multiscale models were used for a consequent analysis of the effects of extracellular ion concentration changes on atrial electrophysiology. Simulations were based on measured electrolyte concentrations from patients with end-stage renal disease. Results: Simulated conduction velocity and effective refractory period are decreased at the end of an HD session, with potassium having the strongest influence. P-wave is prolonged in patients undergoing HD therapy in the simulation as in measurements. Conclusions: Electrolyte concentration alterations impact atrial electrophysiology from the action potential level to the P-wave and can be proarrhythmic, especially because of induced hypokalemia. Analysis of blood electrolytes enables patient-specific electrophysiology modeling. We are providing a tool to investigate atrial arrhythmias associated with HD therapy, which, in the future, can be used to prevent such complications.
Titolo: | Alterations of Atrial Electrophysiology related to Hemodialysis Session: Insights from a Multi-Scale Computer Model. |
Autore/i: | M. Kruger; SEVERI, STEFANO; K. Rhode; S. Genovesi; F. M. Weber; A. Vincenti; P. Fabbrini; G. Seemann; R. Razavi; O. Doessel |
Autore/i Unibo: | |
Anno: | 2011 |
Rivista: | |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.jelectrocard.2010.11.016 |
Abstract: | Background: The prevalence of atrial fibrillation is increased in patients with end-stage renal disease. Previous studies suggested that extracellular electrolyte alterations caused by hemodialysis (HD) therapy could be proarrhythmic. Methods: Multiscale models were used for a consequent analysis of the effects of extracellular ion concentration changes on atrial electrophysiology. Simulations were based on measured electrolyte concentrations from patients with end-stage renal disease. Results: Simulated conduction velocity and effective refractory period are decreased at the end of an HD session, with potassium having the strongest influence. P-wave is prolonged in patients undergoing HD therapy in the simulation as in measurements. Conclusions: Electrolyte concentration alterations impact atrial electrophysiology from the action potential level to the P-wave and can be proarrhythmic, especially because of induced hypokalemia. Analysis of blood electrolytes enables patient-specific electrophysiology modeling. We are providing a tool to investigate atrial arrhythmias associated with HD therapy, which, in the future, can be used to prevent such complications. |
Data prodotto definitivo in UGOV: | 2013-06-28 23:45:31 |
Appare nelle tipologie: | 1.01 Articolo in rivista |