Incidence of arrhythmias and myocardial ischaemia during haemodialysis and haemofiltration.

Thirty-two patients (10 male, 22 female; age 37-82 years) undergoing maintenance haemodialysis or haemofiltration were studied by means of Holter device capable of simultaneously analysing rhythm and ST-changes in three leads. Twenty-five patients were on haemodialysis, seven on haemofiltration, mean duration of haemodialysis/haemofiltration being 3.4 +/- 3 years. Incidence of ventricular tachycardia was low, being detected only in 1 of 32 patients. Ventricular premature beats in excess of 10/h during a period of 2 h were found in 8 of 32 patients and 100 supraventricular premature beats for 2 h or more in 4 of 32 patients. Both ventricular premature beats and supraventricular premature beats were most frequently recorded during the last hour of haemodialysis/haemofiltration. ECG signs of ischaemia were detected in eight patients, four of whom were asymptomatic. Ischaemia also occurred predominantly during the last hour of haemodialysis/haemofiltration. Two symptomatic patients displayed neither arrhythmias nor ST-changes while being monitored. The study shows that silent ischaemia and arrhythmias in patients undergoing chronic haemodialysis/haemofiltration may not be infrequent. Recognition of these events could be of importance in the management of these patients.