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.
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.
Authors: Olaf Dössel; Martin W Krueger; Frank M Weber; Mathias Wilhelms; Gunnar Seemann Journal: Med Biol Eng Comput Date: 2012-06-21 Impact factor: 2.602
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Authors: Nic Smith; Adelaide de Vecchi; Matthew McCormick; David Nordsletten; Oscar Camara; Alejandro F Frangi; Hervé Delingette; Maxime Sermesant; Jatin Relan; Nicholas Ayache; Martin W Krueger; Walther H W Schulze; Rod Hose; Israel Valverde; Philipp Beerbaum; Cristina Staicu; Maria Siebes; Jos Spaan; Peter Hunter; Juergen Weese; Helko Lehmann; Dominique Chapelle; Reza Rezavi Journal: Interface Focus Date: 2011-04-01 Impact factor: 3.906
Authors: Martin W Krueger; Andreas Dorn; David U J Keller; Fredrik Holmqvist; Jonas Carlson; Pyotr G Platonov; Kawal S Rhode; Reza Razavi; Gunnar Seemann; Olaf Dössel Journal: Med Biol Eng Comput Date: 2013-07-18 Impact factor: 2.602
Authors: Natalia A Trayanova; Thomas O'Hara; Jason D Bayer; Patrick M Boyle; Kathleen S McDowell; Jason Constantino; Hermenegild J Arevalo; Yuxuan Hu; Fijoy Vadakkumpadan Journal: Europace Date: 2012-11 Impact factor: 5.214
Authors: Martin W Krueger; Walther H W Schulze; Kawal S Rhode; Reza Razavi; Gunnar Seemann; Olaf Dössel Journal: Med Biol Eng Comput Date: 2012-10-16 Impact factor: 2.602