{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:48:15Z","timestamp":1787496495478,"version":"build-2736575974"},"reference-count":61,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,10]]},"abstract":"\n Background<\/jats:title>\n In patients with end\u2010stage kidney disease, sudden cardiac death is more frequent after a long interdialytic interval, within 6\u00a0hours after the end of a hemodialysis session. We hypothesized that the occurrence of paroxysmal arrhythmias is associated with changes in heart rate and heart rate variability in different phases of hemodialysis.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We conducted a prospective ancillary study of the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease cohort. Continuous\n ECG<\/jats:styled-content>\n monitoring was performed using an\n ECG<\/jats:styled-content>\n patch, and short\u2010term heart rate variability was measured for 3 minutes every hour (by root mean square of the successive normal\u2010to\u2010normal intervals, spectral analysis, Poincar\u00e9 plot, and entropy), up to 300\u00a0hours. Out of enrolled participants (n=28; age 54\u00b113\u00a0years; 57% men; 96% black; 33% with a history of cardiovascular disease; left ventricular ejection fraction 70\u00b19%), arrhythmias were detected in 13 (46%). Nonsustained ventricular tachycardia occurred more frequently during\/posthemodialysis than pre\u2010\/between hemodialysis (63% versus 37%,\n P<\/jats:italic>\n =0.015). In adjusted for cardiovascular disease time\u2010series analysis, nonsustained ventricular tachycardia was preceded by a sudden heart rate increase (by 11.2 [95%\n CI<\/jats:styled-content>\n 10.1\u201312.3] beats per minute;\n P<\/jats:italic>\n <0.0001). During every\u2010other\u2010day dialysis, root mean square of the successive normal\u2010to\u2010normal intervals had a significant circadian pattern (Mesor 10.6 [ 95%\n CI<\/jats:styled-content>\n 0.9\u201311.2] ms; amplitude 1.5 [95%\n CI<\/jats:styled-content>\n 1.0\u20133.1] ms; peak at 02:01 [95%\n CI<\/jats:styled-content>\n 20:22\u201303:16]\n am<\/jats:sc>\n ;\n P<\/jats:italic>\n <0.0001), which was replaced by a steady worsening on the second day without dialysis (root mean square of the successive normal\u2010to\u2010normal intervals \u22121.41 [95%\n CI<\/jats:styled-content>\n \u22121.67 to \u22121.15] ms\/24\u00a0h;\n P<\/jats:italic>\n <0.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Sudden increase in heart rate during\/posthemodialysis is associated with nonsustained ventricular tachycardia. Every\u2010other\u2010day hemodialysis preserves circadian rhythm, but a second day without dialysis is characterized by parasympathetic withdrawal.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013748","type":"journal-article","created":{"date-parts":[[2019,9,28]],"date-time":"2019-09-28T05:02:15Z","timestamp":1569646935000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Hemodialysis Procedure\u2013Associated Autonomic Imbalance and Cardiac Arrhythmias: Insights From Continuous 14\u2010Day ECG Monitoring"],"prefix":"10.1161","volume":"8","author":[{"given":"Nichole M.","family":"Rogovoy","sequence":"first","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey J.","family":"Howell","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany L.","family":"Lee","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick A.","family":"Perez\u2010Alday","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muammar M.","family":"Kabir","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]},{"name":"The Hospital for Sick Children","place":["Canada"]},{"name":"The University of Toronto","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther D.","family":"Kim","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children","place":["Canada"]},{"name":"The University of Toronto","place":["Canada"]},{"name":"Johns Hopkins University","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children","place":["Canada"]},{"name":"The University of Toronto","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose M.","family":"Monroy\u2010Trujillo","sequence":"additional","affiliation":[{"name":"Johns Hopkins University","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle M.","family":"Estrella","sequence":"additional","affiliation":[{"name":"Johns Hopkins University","place":["Baltimore"]},{"name":"University of California","place":["San Francisco"]},{"name":"San Francisco VA Health Care System","place":["San Francisco"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Sozio","sequence":"additional","affiliation":[{"name":"Johns Hopkins University","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard G.","family":"Jaar","sequence":"additional","affiliation":[{"name":"Johns Hopkins University","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rulan S.","family":"Parekh","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children","place":["Canada"]},{"name":"The University of Toronto","place":["Canada"]},{"name":"Johns Hopkins University","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larisa G.","family":"Tereshchenko","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University","place":["Portland"]},{"name":"Johns Hopkins University","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","unstructured":"United States Renal Data System. 2018. 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