Changes in Right Ventricular Pressures Between Hemodialysis Sessions Recorded by an Implantable Hemodynamic Monitor

• Published in: The American journal of cardiology 2009, Vol.103 (1), p.119-123
• Main Authors: Kjellström, Barbro, BMS, PhD, Braunschweig, Frieder, MD, PhD, Löfberg, Erland, MD, PhD, Fux, Thomas, MD, Grandjean, Pierre-Andre, PhD, Linde, Cecilia, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood pressure; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Electrodes, Implanted; Emergency and intensive care: renal failure. Dialysis management; Equipment Design; Female; Follow-Up Studies; Heart; Hemodialysis; Humans; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Male; Medical sciences; Monitoring, Physiologic - instrumentation; Prognosis; Renal Dialysis - methods; Studies; Time Factors; Transplants & implants; Ventricular Dysfunction, Right - etiology; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Right - physiology; Ventricular Pressure - physiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2008.08.038

Intermittent and chronic volume overload might contribute to the onset and progression of cardiovascular disease in patients who are undergoing maintenance hemodialysis (HD). Continuous monitoring of central hemodynamic variables may provide valuable information to improve volume control, particularly in patients with left ventricular dysfunction. Sixteen patients with end-stage renal disease who were undergoing long-term HD received an implantable hemodynamic monitor consisting of a subcutaneously implanted memory device and transvenous right ventricular (RV) lead with a pressure sensor. The implantable hemodynamic monitor continuously records heart rate, RV pressures, and estimated pulmonary arterial (PA) diastolic pressure, an estimate of left ventricular filling pressure. All patients underwent HD 3 times per week, and averages of rest hemodynamic values from the first, second, and third nights after HD during 12 weeks were analyzed. The third night always occurred after the weekend, when there was an extended interval between dialysis sessions. From the first night to the second night, RV systolic pressure increased by 10 ± 8% (p