Timing of Atrial Fibrillation Occurrence in Hemodialysis Patients with Cardiac Implantable Electrical Devices

Abstract

To prospectively investigate the timing and factors associated with the occurrence of atrial fibrillation（AF）in hemodialysis（HD）, we studied 24 HD patients with cardiac implantable electrical devices（male : n＝16, mean age : 74±10 years, Pacemaker : n＝18, Implantable cardioverter defibrillator : n＝3, Cardiac resynchronization therapy defibrillator : n＝3）. We analyzed the occurrence-timing and burden of AF from device-stored data during a mean follow-up period of 9±1 months. Sixteen patients（67％）had at least one AF event. Furthermore, AF events per hour were significantly more frequent during HD than during the other periods without HD（p＜0.01）. The AF burden per hour was significantly higher during HD and from 24 hours before HD to the start of HD than at the other times（p＜0.05）. Patients with AF during HD had significantly lower serum potassium levels than those without AF（4.4±0.2mEq/L vs 4.7±0.2mEq/L, p＝0.01）. The incidence of AF during HD was higher, and low serum potassium level was associated with AF occurrence in HD patients.