Cardiac Arrhythmias in Chronic Renal Failure?

Abstract

25 patients undergoing regular haemodialysis for chronic renal failure underwent Holter ECG monitoring for a continuous 48-hour period covering dialysis and the intermediate period of everyday activity at home. A low dialysate potassium concentration (1.7 mEq/l) was used. Clinically significant arrhythmias ( > 100 ventricular extrasystoles/24 h) were found in only 1 patient and there were no complex ventricular arrhythmias. Benign atrial arrhythmias occurred in 22 patients (88%). Haemodialysis had no influence on type or frequency of arrhythmias.

Hemodialysis-Associated Cardiac Arrhythmias: A Lower Risk with Bicarbonate?

“…The arrhythmogenic effect of hemodialysis has been underlined by some studies (1)(2)(3)(4)(5)(6)(7), but some authors dis agree with this (8)(9)(10)(11). A recent multicenter study carried out on 127 patients with continuous 48-hour Holtermonitoring has emphasized the role of hemodialysis as an arrhythmogenic event (1].…”

“…Risk factors are age > 55 years and left ventricular dysfunction. Most of these studies were performed using acetate as a buffer in the dialysate [1,2,4,5,9,11], but the substitution of bicarbonate for acetate has been reported to improve patient cardiovas cular tolerance during hemodialysis (16,17].…”

“…Various authors [1][2][3][4][5][6][7] have shown that some patients, mostly those with ischemic heart disease, develop cardiac arrhythmias during hemodialytic treatment, although other studies do not support this finding [8][9][10][11]. Nevertheless most previous research has been carried out on patients treated with acetate dialysis (AHD).…”

Ventricular Arrhythmias and Sudden Cardiac Death in End-Stage Renal Disease Patients on Chronic Hemodialysis

“…Hypertension is a well-known risk factor for complex ventricular arrhythmias in patients with essential hypertension [35]. Frequency and severity of ventricular arrhythmias in HD patients have been reported in myocardial perfusion studies [36, 37]to be primarily related to presence of preexisting ventricular dysfunction, CAD, diastolic BP, LV posterior wall thickness, LVMI, and ischemic alterations. However, in a multivariate stepwise analysis, De Lima et al [38]clearly demonstrated that only systolic BP (p < 0.01) and age (p < 0.05) were risk factors for complex ventricular arrhythmias in HD patients after adjustment for other associated factors.…”

Laboratory Markers of Ventricular Arrhythmia Risk in Renal Failure

“…Kyriakidis et al concluded, in a study including 25 hemodialysis patients for chronic renal failure and undergoing Holter ECG monitoring for a continuous 48-hour period, that hemodialysis had no influence on type or frequency of arrhythmia, because they found only benign atrial arrhythmias and no complex ventricular arrhythmias [92]. The most important limitation of the mentioned study is the low number of patients.…”