@article{oai:soar-ir.repo.nii.ac.jp:00007197,
 author = {Shimada,  Kentaro and Tomita,  Takeshi and Kamijo,  Yuji and Higuchi,  Makoto and Ito,  Kenichi and Koizumi,  Yoichi and Yamamoto,  Kazuya and Aizawa,  Kazunori and Koshikawa,  Megumi and Kasai,  Hiroki and Izawa,  Atsushi and Miyashita,  Yusuke and Kumazaki,  Setsuo and Koyama,  Jun and Ikeda,  Uichi},
 issue = {3},
 journal = {CIRCULATION JOURNAL},
 month = {Mar},
 note = {信州大学博士（医学）・学位論文・平成24年1月30日授与（甲第923号）・嶋田健太郎, Background: Atrial fibrillation (AF) is the most common supraventricular arrhythmia, often occurring during hemodialysis (HD). Prolongation of the total filtered P-wave duration (PWD) and reduction of the root mean square voltages for the last 20 ms of the P wave (RMS20) on a P-wave signal-averaged electrocardiogram (P-SAECG) are predictors of AF. We investigated whether HD induces alterations of P-SAECG, and determined the influential factors. Methods and Results: Thirty-three end-stage kidney disease patients (66.7 +/- 12.6 years, 23 males) undergoing maintenance HD were enrolled in this study. Digital ambulatory P-SAECG monitoring and laboratory examination of serum proteins and ions were carried out before, during, and after the HD sessions. Data were analyzed by multiple regression analysis. PWD was significantly prolonged, and RMS20 significantly reduced, during HD. These values recovered after completion of HD. Multiple regression analysis showed that prolongation of PWD significantly correlated with HD duration and the rate of removal of body fluid. On the other hand, RMS20 significantly correlated with HD duration and blood urea nitrogen variation. Conclusions: HD resulted in prolongation of PWD and reduction of RMS20, indicating the vulnerability of HD patients to AF. These P-SAECG changes correlated with HD duration and the rate of removal of the body fluid. These findings underline the importance of the control of dialysis variables in the prevention of atrial arrhythmias following HD. (Circ J 2012; 76: 612-617), Article, CIRCULATION JOURNAL. 76(3):612-617 (2012)},
 pages = {612--617},
 title = {Hemodialysis-Induced P-Wave Signal-Averaged Electrocardiogram Alterations Are Indicative of Vulnerability to Atrial Arrhythmias},
 volume = {76},
 year = {2012}
}