부산대학교 도서관

Twenty-four continuous electrocardiographic monitoring and echocardiographic studies were performed in 21 patients with maintenance hemodialysis because of chronic renal failure. The electrocardiographic monitoring starting 1 hour prior to the dialysis revealed ventricular premature beats in 7 cases (33%). The ventricular premature beats were frequent during the middle and later period of the dialysis as well as during 6 hours thereafter. Although both the systolic and diastolic dimensions of the left ventricle were decreased following the dialysis, the ejection fraction was not influenced. Potentially hazardous ventricular premature beats, such as frequent more than 30/hour, coupled or runs, were observed in 4 cases (19%). The systolic and diastolic dimensions of the left ventricle determined by echocardiography were significantly increased and the ejection fraction was decreased in these patients as compared with those without serious arrhy-thmias. All these 4 patients were hypertensive, while 2 had old myocardial infarction and 2 had histories of congestive heart failure. The present study suggests that a cautious electrocardiographic monitoring is necessary during and after the hemodialysis in the presence of low cardiac function or pre-existing heart disease.