Abstract
Our study was to elucidate the feature of dialysis patients with atrial fibrillation (AF). We examined patients with (AF group ; n=29) and without AF (control group ; n=30) who underwent dialysis therapy in our institution. The duration of dialysis was comparable between the two groups. We evaluated their clinical characteristics, laboratory data and echocardiographic parameters. Age (p=0.040), left atrial diameter (LAD) (p=0.001), presence of valvular disease (p=0.023) and old cerebral infarction (OCI) (p=0.003) were significantly greater and the number of patients prescribed angiotensin converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) was significantly smaller in the AF group. Furthermore, the duration of dialysis (p=0.049), LAD (p=0.019) and presence of valvular disease (p=0.001) were significantly greater in patients with chronic AF (n=12) than in those with paroxysmal AF (n=17). In the AF group, anticoagulant therapy was insufficient in patients with OCI. In addition, rhythm control was poor in patients with paroxysmal AF despite the administration of antiarrhythmic drugs.
These findings suggest that age, the duration of dialysis therapy and presence of valvular disease contribute to the occurrence of AF in dialysis patients. We consider that it is difficult for patients with AF to undergo rhythm control therapy. Furthermore, we suggest that ACE-I and ARB might be associated with the prevention of AF in dialysis patients.
