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

Research output: Contribution to journalArticlepeer-review


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
Issue number5
Publication statusPublished - Nov 2005


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

ASJC Scopus subject areas

  • Nephrology


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