Incidence of Atrial Fibrillation in Hemodialysis Patients. A Prospective Long-Term Follow-Up Study

• Published in: Revista española de cardiologia 2006-08, Vol.59 (8), p.779-784
• Main Authors: de Castroviejo, Eduardo Vázquez-Ruiz, Sánchez-Perales, Carmen, Lozano-Cabezas, Cristóbal, García-Cortés, María José, Guzmán-Herrera, Manuel, Borrego-Utiel, Francisco, López-López, Juana, Pérez-Bañasco, Vicente
• Format: Article
• Language: eng ; spa
• Subjects: Aged; Arrhythmia; Arritmia; Atrial Fibrillation - epidemiology; Embolism; Embolismo; Female; Follow-Up Studies; Humans; Incidence; Kidney; Male; Middle Aged; Prospective Studies; Renal Dialysis; Riñón; Time Factors
• ISSN: 1885-5857; 0300-8932; 1885-5857
• DOI: 10.1016/S1885-5857(07)60043-7

Although atrial fibrillation (AF) is the most commonly occurring arrhythmia in the general population and is a serious health problem, its incidence in patients on hemodialysis is unknown. Our objectives were to determine the incidence of AF in our hemodialysis patients, to investigate factors that predispose to its occurrence, and to assess the clinical implications of AF. In total, 164 patients in sinus rhythm (SR) were followed for seven years. The occurrence of AF and its influence on mortality and on the occurrence of thromboembolic events were recorded. In a mean follow-up period of 47±29.5 months (i.e., 643.2 patient-years), 20 patients developed AF (3.1 per 100 patient-years). It was not possible to identify factors that predisposed to the arrhythmia. In patients aged >65 years, 1-year and 2-year mortality rates following the occurrence of AF were 38% and 53%, respectively, whereas the rates in those who remained in SR were 14% and 31%, respectively (P =NS). The development of AF was not found to be an independent predictor of mortality. Five patients in the AF group experienced 6 thromboembolic episodes in a follow-up period of 23.6 (21.4) months (i.e., 15 episodes per 100 patient-years), compared with 3 episodes per 100 patient-years in the SR group (relative risk=5.2; 95% CI, 2.1–12.4). Each year, 3 in every 100 patients in our dialysis unit developed AF. The occurrence of AF increased the risk of a thromboembolic complication 5-fold. The use of anticoagulant treatment in these patients should be carefully evaluated. Aunque la fibrilación auricular (FA) es la arritmia más frecuente en la población y constituye un relevante problema social y sanitario, su incidencia en los pacientes en hemodiálisis es desconoci-da. El objetivo es determinar la incidencia de FA en nues-tra población en hemodiálisis, analizar los factores que condicionan su aparición y su influencia en la evolución clínica. Seguimos, durante 7 años, a 164 pacientes que se encontraban en ritmo sinusal (RS). Determinamos la aparición de FA y su influencia en la mortalidad y en la aparición de fenómenos tromboembólicos. Durante un seguimiento medio de 47 ± 29,5 meses (643,2 pacientes-año), 20 pacientes desarro-llaron FA (3,1/100 pacientes-año), sin que se identificaran los factores que condicionaron la aparición de la arritmia. En el grupo > 65 años, la mortalidad al primer y segundo año tras la aparición de FA fue del 38 y el 53%, respecti-vamente, mientras que en los pacientes que m