Influence of Electrolyte Concentration Changes on Sinus Node Function - A new player regarding sudden cardiac death in patients with chronic kidney disease?
With a prevalence of 7%, chronic kidney disease (CKD) affects more than 30 million patients in the European Union. These patients have a 17-fold increase regarding the risk of cardiovascular events. In case of patients suffering from CKD, the kidneys are not able to sustain normal blood electrolyte concentrations. Hemodialysis is the treatment of choice worldwide for chronic and acute kidney failure. It is used to restore electrolyte concentrations within the physiological limits. However, transient electrolyte changes during the inter-dialysis period are significant.
Sudden cardiac death (SCD) is the most frequent cause of death for patients with CKD. So far, ventricular fibrillation was assumed to be the main reason. However, a recent study identified bradycardia or asystole as the causes for sudden cardiac death in a majority of CKD patients. Therefore, the effect of electrolyte concentration changes on the sinus node needs to be further understood and investigated. Computational modeling provides unique opportunities to analyze such influences on cardiac electrophysiology under controlled conditions.
The aim of this work is to assess the effects on the sinus node comprehensively. In particular, the influence of the electrolyte concentration changes on the mechanisms of excitation generation by the sinus node will be identified.