Key result
Amelioration of peripheral edema significantly increased QRS duration from 90.1 to 101.7 milliseconds (P=0.001), an apparent increase likely mediated by alterations in body volume conductor impedance.
Why the study?
Does fluid removal increase measured QRS duration in patients with peripheral edema or undergoing hemodialysis?
Observational (n=41)
Does fluid removal increase measured QRS duration in patients with peripheral edema or undergoing hemodialysis?
Answers are grounded in this paper and cite their sources.
Fluid removal in patients with peripheral edema or undergoing hemodialysis leads to an apparent increase in QRS duration, likely due to changes in body impedance rather than true electrophysiological changes.
Association among weights, amplitude of QRS complexes, and QRS duration in patients with peripheral edema has been described. This study explored whether increase in QRS duration occurs with amelioration of peripheral edema or after hemodialysis. Sums of the amplitudes of the 12 electrocardiographic leads and corresponding QRS duration were measured in 12 patients with peripheral edema before and after loss of weight, in 28 patients with a critical illness but without change in their weight ("controls"), and in 1 patient before and after hemodialysis. QRS duration increased from 90.1+/-25.0 milliseconds to 101.7+/-25.8 milliseconds (P=.001) in patients with peripheral edema, was unchanged in the controls, and increased from 87.8+/-5.9 milliseconds before to 92.7+/-6.7 milliseconds after hemodialysis (P=.007). It is proposed that these increases in QRS duration are only apparent (not electrophysiologically real), representing an extracardiac phenomenon mediated by alterations in the composite impedance of the passive body volume conductor, resulting in measurement of augmented QRS complexes after fluid removal. The clinical implications for patients with congestive heart failure are discussed.
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John E. Madias (2006) conducted an observational in Peripheral edema (n=41). Fluid removal (amelioration of peripheral edema or hemodialysis) vs. Baseline (before fluid removal) and controls without weight change was evaluated on QRS duration (p=0.001). Amelioration of peripheral edema significantly increased QRS duration from 90.1 to 101.7 milliseconds (P=0.001), an apparent increase likely mediated by alterations in body volume conductor impedance.
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