ELECTROCARDIOGRAM PATTERN PRE AND 24 HOURS POST THERAPY IN HYPONATREMIA WITH HEART FAILURE PATIENT

Abstract

Background : Hyponatremia is the most common electrolyte disturbance in hospitalized heart failure patients, with a prevalence of around 19%-25%. The relationship between hyponatremia and cardiac conduction disorders has not been demonstrated yet. When there is a decrease in extracellular Na+ levels, there is a delay in the depolarization phase. This study was conducted to observe the ECG pattern in hyponatremic patients with heart failure (particularly in the P wave, PR interval, and QRS complex) and ECG changes after 24 hours of therapy. Methode: This study used a longitudinal observational descriptive method. Patients who were included in this study were hyponatremic patients with heart failure at the Wahidin Sudirohusodo Hospital Makassar from April to September 2021. The patient's electrocardiogram data when first admitted and after 24 hours of therapy. Statistical test using McNemar and Wilcoxon Signed Rank Test, where the test results are statistically significant when the p value <0.05. Result : This study included 51 subjects with a distribution of 68.6% men with an age range of 18-85 years. Pre-therapy ECG pattern showed 12 patients with prolonged P-R interval, and 4 patients with widening of the QRS complex. After 24 hours of therapy, 12 people became normonatremia and the mean P wave and P-R interval were lower than pre-therapy, while the QRS complex did not show any changes. Conclusion : The ECG pattern in hyponatremia with heart failure are prolonged P-R interval and widening of the QRS complex, but the ECG changes were not significant to Na+ levels changes.