Variations of P wave duration and dispersion in patients treated with periodic hemodialysis

Introduction: P wave duration and dispersion are noninvasive markers for the predicdon of atrial fibrillation risk in patients treated with hemodialysis. Objective: To determine P wave variations and dispersion in patients with stage 5 chronic kidney disease treated with periodic hemodialysis. Method: A longitudinal, observational, prospective study was carried out from October 2016 to April 2018. Results: Seventy-one patients (47 males) were included, averaging 56 years of age; P wave duration at the beginning of hemodialysis was 75.91 milliseconds and at the end was 81.2; p<0.001. Maximum P wave increased from 9525 to 101.16 milliseconds; p<0.001. P wave dispersion did not show significant changes. In patients with more than one-year arteriovenous fistula, P wave dispersion increased from 35 milliseconds to 43.6 at the end of hemodialysis, with no significant differences. Increases in maximum P wave duration were significant regardless of smaller or larger left atrial size. P wave dispersion did not show significant differences when compared with left atrial size. Thrombolysis percentage in Group II was higher than 50% in most of the centers. Conclusions: P wave dispersion did not show significant changes during hemodialysis as has been observed in different international studies. Average/maximum P wave duration show significant increases that are probably the expression of changes in the heterogeneity of atrial conduction in the sample studied.