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Holter electrocardiographic recordings were performed for 24 hours in 20 patients on chronic hemodialysis to evaluate the effect of changes in serum calcium and potassium during a 5-hour hemodialysis period on the QT interval. Hemodialysis caused an acute increase in serum calcium from a predialysis value of 9.6 +/- 1.3 mg/dl to 11.5 +/- 1.2 mg/dl and a decrease in serum potassium from 4.9 +/- 0.6 mEq/L to 3.5 +/- 0.4 mEq/L. The Q-oTc interval shortened from a predialysis value of 0.240 +/- 0.023 sec to a minimum of 0.215 +/- 0.022 sec during the 5th hour of hemodialysis. This Q-oTc interval shortening was correlated strongly with an increase in serum calcium and was statistically significant only in subjects showing an increase in serum calcium of more than 2 mg/dl (p less than 0.05). The Q-eTc interval increased from a predialysis value of 0.392 +/- 0.030 sec to 0.414 +/- 0.024 sec during the 4th hour of hemodialysis. This Q-eTc interval prolongation was correlated with a decrease in serum potassium. It was concluded that increased serum calcium during hemodialysis caused shortening of the Q-oTc interval, that the degree of shortening was proportional to the magnitude of increase in serum calcium, and that changes in serum calcium and the Q-oTc interval were concurrent. It was also concluded that hemodialysis resulted in prolongation of the Q-eTc interval. This change was possibly caused by a decrease in the level of serum potassium during the procedure.

Effects of combined changes in serum calcium and potassium on QT interva. A study by holter electrocardiographic monitoring during hemodialysis.