Association of Fragmented QRS Morphology With Risk of Atrial Fibrillation in Hemodialysis Patients

Abstract

Association of Fragmented QRS Morphology With Risk of Atrial Fibrillation in Hemodialysis Patients

Abstract

Objective: Atrial fibrillation (AF) is the most common form of arrhythmia in hemodialysis (HD) patients. Fragmented QRS (fQRS) morphology has been proposed as an ECG marker to predict the risk of paroxysmal AF in various conditions. In this study, we aimed to investigate the association between risk of AF development and P dispersion (Pd) and fQRS morphology in HD patients. Methods: After analyzing the 24-hour Holter recordings of the patients, they were divided into 3 groups as without atrial runs (WAR), short atrial runs (SAR), and silent paroxysmal atrial fibrillation episode (SPAFE). In ECGs taken before HD, the presence of fQRS morphology was investigated, and Pd was measured. Results: As a result of the analysis of the 24-hour Holter ECG recordings, it was determined that 12 of the 74 patients had SAR, while 6 had SPAFE. The duration of hemodialysis was significantly longer in the SPAFE groups than the WAR group (p=0.026). It was found that fQRS morphology could be an independent predictor of SAR (odds ratio=0.056; 95% CI, 0.006–0.548; p=0.013). The incidence of fQRS morphology was significantly higher in the SPAFE group than the WAR group (p=0.002). However, this significance did not continue in the multivariate analysis. Pd was similar between the groups. Conclusion: This retrospective study is the first study that investigated the association of fQRS morphology with SAR and SPAFE in HD patients, and it showed that fQRS morphology may be useful in distinguishing HD patients with a high AF risk.

Keywords

• trial fibrillation
• fragmented QRS
• hemodialysis

References

1. 1.Yıldız BS, Aladag NB, Kaptanogullari H, Sahin A. ThePrevalence of Atrial Fibrillation and Related FactorsIncluding Anthropometric, Hemodynamic andEchocardiographic Parameters in Patients with Hemodialysis. Kosuyolu Kalp Derg 2013; 16: 229-32.