RT Journal Article
SR Electronic
T1 The dialysis procedure as a trigger for atrial fibrillation: new insights in the development of atrial fibrillation in dialysis patients
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2013-305417
DO 10.1136/heartjnl-2013-305417
A1 M S Buiten
A1 M K de Bie
A1 J I Rotmans
A1 B A Gabreëls
A1 W van Dorp
A1 R Wolterbeek
A1 S A Trines
A1 M J Schalij
A1 J W Jukema
A1 T J Rabelink
A1 L van Erven
YR 2014
UL http://heart.bmj.com/content/early/2014/03/26/heartjnl-2013-305417.abstract
AB Aims Atrial fibrillation (AF) is common in dialysis patients and is associated with increased morbidity and mortality. The pathophysiology may be related to common risk factors for both AF and renal disease or to dialysis-specific factors. The purpose of this study was to determine whether and how AF onset relates to the dialysis procedure itself. Methods All dialysis patients enrolled in the implantable cardioverter defibrillator-2 (ICD-2) trial until January 2012, who were implanted with an ICD, were included in this study. Using the ICD remote monitoring function, the exact time of onset of all AF episodes was registered. Subsequently, this was linked to the timing of dialysis procedures. Results For the current study, a total of 40 patients were included, follow-up was 28±16 months, 80% male, 70±8 years old. A total of 428 episodes of AF were monitored in 14 patients. AF onset was more frequent on the days of haemodialysis (HD) (p<0.001) and specifically increased during the dialysis procedure itself (p=0.04). Patients with AF had a larger left atrium (p<0.001) and a higher systolic blood pressure before and after HD (p<0.001). Conclusion This study provides insight in the exact timing of AF onset in relation to the dialysis procedure itself. In HD patients, AF occurred significantly more often on a dialysis day and especially during HD. These findings might help to elucidate some aspects of the pathophysiology of AF in dialysis patients and could facilitate early detection of AF in these high-risk patients.