Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients

Simonetta Genovesi, Daniela Pogliani, Andrea Faini, Maria G. Valsecchi, Alessandra Riva, Francesca Stefani, Irene Acquistapace, Andrea Stella, Giuseppe Bonforte, Amedeo DeVecchi, Vincenzo DeCristofaro, Gherardo Buccianti, Antonio Vincenti

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Abstract

Background: Hemodialysis (HD) is associated with cardiovascular structural modifications; moreover, during HD, rapid electrolytic changes occur. Both factors may favor the onset of atrial fibrillation. Methods: To define the prevalence of atrial fibrillation and identify associated factors, 488 patients on long-term HD therapy (age, 66.6 ± 13.4 years; men, 58.0%; duration of HD, 76.5 ± 84.3 months) were studied. Results: Atrial fibrillation was reported in 27.0% of patients; paroxysmal in 3.5%, persistent in 9.6%, and permanent in 13.9%. Clinical and echocardiographic variables were considered: patients with atrial fibrillation were older (71.8 ± 9.3 versus 64.7 ± 14.2 years; P <0.01), and its prevalence increased with age. Patients with arrhythmia had a longer duration of dialysis therapy (93.2 ± 100.5 versus 70.2 ± 76.7 months; P = 0.02). Atrial fibrillation was associated significantly with ischemic heart disease (P <0.01), dilated cardiomyopathy (P <0.01), acute pulmonary edema (P <0.05), valvular disease (P <0.05), cerebrovascular accidents (P <0.05), and predialytic hyperkalemia (P <0.05). Patients with atrial fibrillation more frequently showed left atrial dilatation (59.8% versus 34.5%; P <0.0001), and in these subjects, left ventricular ejection fraction was significantly lower (53.9% versus 57.4%; P = 0.029). No association was found between arrhythmia and hypertension or diabetes. Multivariate analysis confirmed that patient age (P <0.001), duration of HD therapy (P = 0.001), and left atrial dilatation (P <0.001) were associated with atrial fibrillation. Conclusion: Atrial fibrillation is much more frequent in HD patients than in the general population; age, duration of HD history, presence of some heart diseases, and left atrial dilatation are associated with the arrhythmia.

Original languageEnglish
Pages (from-to)897-902
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume46
Issue number5
DOIs
Publication statusPublished - Nov 2005

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Atrial Fibrillation
Renal Dialysis
Population
Cardiac Arrhythmias
Dilatation
Hyperkalemia
Dilated Cardiomyopathy
Pulmonary Edema
Stroke Volume
Myocardial Ischemia
Dialysis
Heart Diseases
Therapeutics
Multivariate Analysis
History
Stroke
Hypertension

Keywords

  • Atrial fibrillation
  • Cardiovascular diseases
  • Echocardiography
  • Hemodialysis (HD)

ASJC Scopus subject areas

  • Nephrology

Cite this

Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients. / Genovesi, Simonetta; Pogliani, Daniela; Faini, Andrea; Valsecchi, Maria G.; Riva, Alessandra; Stefani, Francesca; Acquistapace, Irene; Stella, Andrea; Bonforte, Giuseppe; DeVecchi, Amedeo; DeCristofaro, Vincenzo; Buccianti, Gherardo; Vincenti, Antonio.

In: American Journal of Kidney Diseases, Vol. 46, No. 5, 11.2005, p. 897-902.

Research output: Contribution to journalArticle

Genovesi, S, Pogliani, D, Faini, A, Valsecchi, MG, Riva, A, Stefani, F, Acquistapace, I, Stella, A, Bonforte, G, DeVecchi, A, DeCristofaro, V, Buccianti, G & Vincenti, A 2005, 'Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients', American Journal of Kidney Diseases, vol. 46, no. 5, pp. 897-902. https://doi.org/10.1053/j.ajkd.2005.07.044
Genovesi, Simonetta ; Pogliani, Daniela ; Faini, Andrea ; Valsecchi, Maria G. ; Riva, Alessandra ; Stefani, Francesca ; Acquistapace, Irene ; Stella, Andrea ; Bonforte, Giuseppe ; DeVecchi, Amedeo ; DeCristofaro, Vincenzo ; Buccianti, Gherardo ; Vincenti, Antonio. / Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients. In: American Journal of Kidney Diseases. 2005 ; Vol. 46, No. 5. pp. 897-902.
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abstract = "Background: Hemodialysis (HD) is associated with cardiovascular structural modifications; moreover, during HD, rapid electrolytic changes occur. Both factors may favor the onset of atrial fibrillation. Methods: To define the prevalence of atrial fibrillation and identify associated factors, 488 patients on long-term HD therapy (age, 66.6 ± 13.4 years; men, 58.0{\%}; duration of HD, 76.5 ± 84.3 months) were studied. Results: Atrial fibrillation was reported in 27.0{\%} of patients; paroxysmal in 3.5{\%}, persistent in 9.6{\%}, and permanent in 13.9{\%}. Clinical and echocardiographic variables were considered: patients with atrial fibrillation were older (71.8 ± 9.3 versus 64.7 ± 14.2 years; P <0.01), and its prevalence increased with age. Patients with arrhythmia had a longer duration of dialysis therapy (93.2 ± 100.5 versus 70.2 ± 76.7 months; P = 0.02). Atrial fibrillation was associated significantly with ischemic heart disease (P <0.01), dilated cardiomyopathy (P <0.01), acute pulmonary edema (P <0.05), valvular disease (P <0.05), cerebrovascular accidents (P <0.05), and predialytic hyperkalemia (P <0.05). Patients with atrial fibrillation more frequently showed left atrial dilatation (59.8{\%} versus 34.5{\%}; P <0.0001), and in these subjects, left ventricular ejection fraction was significantly lower (53.9{\%} versus 57.4{\%}; P = 0.029). No association was found between arrhythmia and hypertension or diabetes. Multivariate analysis confirmed that patient age (P <0.001), duration of HD therapy (P = 0.001), and left atrial dilatation (P <0.001) were associated with atrial fibrillation. Conclusion: Atrial fibrillation is much more frequent in HD patients than in the general population; age, duration of HD history, presence of some heart diseases, and left atrial dilatation are associated with the arrhythmia.",
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AU - Pogliani, Daniela

AU - Faini, Andrea

AU - Valsecchi, Maria G.

AU - Riva, Alessandra

AU - Stefani, Francesca

AU - Acquistapace, Irene

AU - Stella, Andrea

AU - Bonforte, Giuseppe

AU - DeVecchi, Amedeo

AU - DeCristofaro, Vincenzo

AU - Buccianti, Gherardo

AU - Vincenti, Antonio

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N2 - Background: Hemodialysis (HD) is associated with cardiovascular structural modifications; moreover, during HD, rapid electrolytic changes occur. Both factors may favor the onset of atrial fibrillation. Methods: To define the prevalence of atrial fibrillation and identify associated factors, 488 patients on long-term HD therapy (age, 66.6 ± 13.4 years; men, 58.0%; duration of HD, 76.5 ± 84.3 months) were studied. Results: Atrial fibrillation was reported in 27.0% of patients; paroxysmal in 3.5%, persistent in 9.6%, and permanent in 13.9%. Clinical and echocardiographic variables were considered: patients with atrial fibrillation were older (71.8 ± 9.3 versus 64.7 ± 14.2 years; P <0.01), and its prevalence increased with age. Patients with arrhythmia had a longer duration of dialysis therapy (93.2 ± 100.5 versus 70.2 ± 76.7 months; P = 0.02). Atrial fibrillation was associated significantly with ischemic heart disease (P <0.01), dilated cardiomyopathy (P <0.01), acute pulmonary edema (P <0.05), valvular disease (P <0.05), cerebrovascular accidents (P <0.05), and predialytic hyperkalemia (P <0.05). Patients with atrial fibrillation more frequently showed left atrial dilatation (59.8% versus 34.5%; P <0.0001), and in these subjects, left ventricular ejection fraction was significantly lower (53.9% versus 57.4%; P = 0.029). No association was found between arrhythmia and hypertension or diabetes. Multivariate analysis confirmed that patient age (P <0.001), duration of HD therapy (P = 0.001), and left atrial dilatation (P <0.001) were associated with atrial fibrillation. Conclusion: Atrial fibrillation is much more frequent in HD patients than in the general population; age, duration of HD history, presence of some heart diseases, and left atrial dilatation are associated with the arrhythmia.

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KW - Atrial fibrillation

KW - Cardiovascular diseases

KW - Echocardiography

KW - Hemodialysis (HD)

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