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Abstract: FR-PO403

Silent Arrhythmias In Hemodialysis Patients Does Not Increase Major Cardiovascular Events over Short-Term Follow-Up

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Jeloka, Tarun K., Aditya Birla Memorial Hospital, Pune, MAHARASHTRA, India
  • Somani, Jaymin Pradipkumar, Aditya Birla Memorial Hospital, Pune, MAHARASHTRA, India
  • Mali, Manishkumar Shantaram, Aditya Birla Memorial Hospital, Pune, MAHARASHTRA, India
  • Kale, Gajanan Kishor, Aditya Birla Memorial Hospital, Pune, MAHARASHTRA, India
Background

This study was conducted to know the incidence and outcome of silent cardiac arrhythmias in hemodialysis patients.

Methods

A total of 25 patients on regular hemodialysis (HD) were enrolled for studying cardiac arrhythmias. At screening phase, all HD patients were subjected to fluid optimization and adjustment in the BP medicines over a period of 2 weeks. Only those patients, who had no history of or evidence of arrhythmias in baseline electrocardiogram were enrolled. Holter monitoring for evidence of arrhythmia was done for 24 hours, including 4 hours of hemodialysis session on two occasions: long interdialytic (LIDP) and short interdialytic period (SIDP). Incidence and types of arrhythmia was noted. Factors associated with arrhythmias and effect of interdialytic period on arrhythmia were studied. All these patients were followed for a period of 12 months to study the impact of cardiac arrhythmias to adverse cardiovascular events.

Results

Out of 25 patients studied, 17 patients (68%) developed arrhythmia. Of all the arrhythmias, sinus bradycardia was the most common type, which occurred in 60% of patients. Incidence of supraventricular tachycardia (SVT) was 24% followed by atrial tachycardia 16%, premature ventricular complex 12%, atrial fibrillation 8%, premature atrial complex 4% and ventricular tachycardia 4%. The baseline demographic parameters of patients with or without arrhythmias were similar. In laboratory parameters, serum creatinine was higher in arrhythmia group (9.2 mg/dl vs 6.9 mg/dl, P=0.003). Mean ultrafiltration was higher in arrhythmia group after long inter-dialytic period (2.86 ± 0.68L vs. 2.12 ± 0.93L, P = 0.036). Incidence of arrhythmia was higher after LIDP as compared to SIDP (64% vs. 52%, p=0.004). A total of 4 patients died over 1 year of follow up - three patients died in non-arrhythmia group while one in the arrhythmia group. One patient in arrhythmia group developed heart failure. None of the patients developed symptomatic cardiovascular event over 12 months of short observational period.

Conclusion

Asymptomatic silent arrhythmia is a common complication seen in patients on maintenance hemodialysis (68%) with bradycardia being the commonest (60%). Impact of arrhythmia on long term cardiovascular outcome needs long term follow up of these patients.