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Ter Arkh. 2007;79(4):18-23.

[Increased QRS voltage during dehydrating].

[Article in Russian]

Abstract

AIM:

To assess QRS voltage changes with lower total amount of biological fluids under ultrafiltration during hemodialysis.

MATERIALS AND METHODS:

The study included 14 patients with chronic renal failure. An average of 2.5 +/- 0.24 liters of fluid were removed during a session. 12-lead standard ECG was continuously recorded by means of a computer-aided cardiac recorder throughout the session of hemodialysis. Changes in the amplitude of QRS waves were analyzed in each lead.

RESULTS:

Elevated QRS voltage was most pronounced in the anterior chest leads (v1-v4). Moreover, the potentials corresponding to the propagation of a predominant excitation front over the cardiac surface facing both the anterior chest wall--QRS+ (R wave) and the posterior chest wall--ORS-(S or Q waves) increased in most cases. Voltage changes in these leads were observed in 90% of patients, the amplitude of the waves being increased by more than 0.5 mV.

CONCLUSION:

During dehydration, lower chest tissue electroconductivity may cause a considerable increase in QRS voltage. This should be kept in mind while analyzing ECG data during both a session of hemodialysis and antihypertensive therapy resulting in some fluid loss, as well as in the treatment of cardiac and renal failure, leading to diminished concomitant edemas.

PMID:
17564013
[PubMed - indexed for MEDLINE]
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