Abstract: TH-PO1281
Spectrum and Burden of Arrhythmias in Patients with ESKD on Maintenance Hemodialysis: A 48-Hour Holter Monitoring Study
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Singh, Barundeep, Indian Naval Hospital Ship Asvini, Mumbai, MH, India
- Chawla, M. P. S., Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, DL, India
- Sambyal, Bharat S., Indian Naval Hospital Ship Asvini, Mumbai, MH, India
- Chauhan, Prabhat, Indian Naval Hospital Ship Asvini, Mumbai, MH, India
- Kaur, Chrisinder, Indian Naval Hospital Ship Asvini, Mumbai, MH, India
- Ramamoorthy, Ananthakrishnan, Indian Naval Hospital Ship Asvini, Mumbai, MH, India
Background
Arrhythmias are a major contributor to cardiovascular mortality in patients with end-stage kidney disease (ESKD) on maintenance hemodialysis. Despite this, prospective data regarding the peridialytic rhythm profile, particularly in South Asian cohorts, remain limited. We aimed to characterize the spectrum and burden of arrhythmias across the dialysis cycle using 48 hour Holter monitoring.
Methods
In this cross sectional observational study, we consecutively enrolled 50 adult patients with ESKD who were receiving maintenance hemodialysis (≥1 month) at our tertiary care centre between July 2022 and Dec 2023. After institutional ethics approval and informed consent, all participants underwent continuous 48 hour Holter monitoring, capturing pre-dialysis, intradialytic, and post-dialysis periods. We recorded demographic, clinical, and dialysis related parameters. Ventricular ectopy was categorized as "complex" when Holter monitoring showed any of the following: ventricular couplets, triplets, trigeminy, quadrigeminy, or ≥ 3 ventricular ectopy beats within a 30 second window.
Results
The cohort (mean age 56.7 ± 13.3 years; 52% male) presented with a significant comorbidity burden: hypertension (66%), diabetes (32%), and ischemic heart disease (8%). Most patients (76%) underwent 4 hour hemodialysis sessions, primarily via an arteriovenous fistula (94%). Mean systolic blood pressure decreased from 130.8 ± 18.0 to 127.9 ± 16.4 mmHg (p < 0.001) post-dialysis.
Arrhythmia prevalence was high: 23 patients (46%) had isolated PVCs, while 5 patients (10%) exhibited complex ventricular ectopy. Supraventricular ectopic activity occurred in 13 patients (26%). Short runs of PSVT in 4 patients (8%), and junctional rhythms in 3 patients (6%). Other abnormalities, each occurring in a single patient (2%), included intermittent pre-excitation, multifocal atrial tachycardia, a 2.6 second pause. Brady- and tachyarrhythmic findings were common, including sinus tachycardia (36%) and sinus bradycardia (34%).
Conclusion
≥50 % of dialysis patients manifested ventricular ectopy, reflecting electrical lability. Ambulatory monitoring can flag those at higher cardiovascular risk. Prospective longitudinal studies are needed to link these rhythm disturbances to long term outcomes and test whether modifiable dialysis parameters can mitigate that risk.