Disturbances in intraventricular conduction in children with end-stage renal disease on peritoneal dialysis: A pilot study

Adv Clin Exp Med. 2018 Sep;27(9):1225-1231. doi: 10.17219/acem/69255.

Abstract

Background: The progression of chronic kidney disease is accompanied by multi-organ disorders, among which cardiovascular diseases have the status of a serious clinical problem. The body surface potential mapping (BSPM) technique is a non-invasive method which enables the detection of pathological changes in the bioelectrical activity of the heart.

Objectives: The aim of this study was to identify possible disturbances in the intraventricular conduction system in peritoneally dialyzed children.

Material and methods: Cardiac examination consisted of 12-lead electrocardiography, echocardiography and BSPM. The evaluation of disturbances in the cardio-electrical field was performed by comparing the qualitative and quantitative features of the heart potentials on the isopotential map.

Results: Data was collected from 10 children treated with automatic peritoneal dialysis (APD) (mean age: 13.6 ±2.3 years) and 26 healthy children. The maps of dialyzed children showed a shift in positive isopotentials toward the left lower part of the thorax, while negative values were observed in its left upper part. A distribution of lines on the isopotential maps revealed disturbances in the stimulation spread within the heart ventricles, especially within the anterior fascicle of the left bundle branch of His.

Conclusions: Intraventricular conduction disturbances were observed in the left bundle branch of His in the peritoneally dialyzed children. The body surface potential mapping was a more sensitive method in identifying the early stage of conduction disturbances within the heart ventricles than 12-lead electrocardiography. Further research involving a larger population of dialyzed children is planned.

Keywords: body surface potential mapping; children; isopotential maps; peritoneal dialysis.

MeSH terms

  • Adolescent
  • Body Surface Potential Mapping*
  • Bundle of His*
  • Child
  • Echocardiography
  • Electrocardiography
  • Female
  • Heart Conduction System / physiopathology*
  • Heart Ventricles / physiopathology
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Male
  • Peritoneal Dialysis / adverse effects*
  • Pilot Projects