Implantable Loop Recorder Monitoring and the Incidence of Previously Unrecognized Atrial Fibrillation in Patients on Hemodialysis.
| Autor: | Koplan BA; Cardiology Division, Brigham & Women's Hospital, Boston, Massachusetts, USA., Winkelmayer WC; Section of Nephrology, Baylor College of Medicine, Houston, Texas, USA., Costea AI; Cardiology Division, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA., Roy-Chaudhury P; Department of Medicine, University of North Carolina Kidney Center, Chapel Hill, North Carolina, USA.; Department of Medicine, WG (Bill) Hefner VA Medical Center, Salisbury, North Carolina, USA., Tumlin JA; Georgia Nephrology Clinical Research Institute, Atlanta, Georgia, USA., Kher V; Medanta Kidney & Urology Institute, Medanta, The Medicity, Gurugram, India., Williamson DE; Southeastern Clinical Research Institute, Augusta, Georgia, USA., Pokhariyal S; Division of Nephrology and Renal Transplantation, Manipal Hospitals, Dwarka, New Delhi, India., Charytan DM; Nephrology Division, NYU Grossman School of Medicine, New York, New York, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Kidney international reports [Kidney Int Rep] 2021 Oct 16; Vol. 7 (2), pp. 189-199. Date of Electronic Publication: 2021 Oct 16 (Print Publication: 2022). |
| DOI: | 10.1016/j.ekir.2021.10.001 |
| Abstrakt: | Introduction: Atrial fibrillation (AF) is common in patients with kidney failure on hemodialysis (KF-HD). We determined both AF incidence and burden in patients with KF-HD using implantable loop recorder (ILR) monitoring . Methods: Patients with KF-HD were enrolled and received an ILR. In 6 monitoring months, the incidence of AF events lasting ≥6 minutes was captured. Demographic, clinical, and dialysis characteristics were collected, and associations with incident AF were estimated using negative binomial regression models and expressed as incidence rate ratios and 95% CIs. Results: We enrolled 66 patients with KF-HD (mean age = 56 years, 70% male); 59 (90%) were without previously diagnosed AF. AF lasting ≥6 minutes was detected in 18 of 59 subjects (31%) without previously diagnosed AF and in 5 of 7 subjects (71%) with a previous AF diagnosis. Among the 23 with detected AF, episodes were present on 16% of patient days. Although 14 of 23 patients (61%) had AF on <5% of monitored days, the average duration of AF episodes was <1 hour in 13 of 23 patients (52%). Among patients with AF ≥6 minutes, 19 of 23 (83%) had a CHA Conclusion: New AF was detected in approximately one-third of patients with KF-HD. AF affects a substantial proportion of patient days and may be an underappreciated cause of stroke in KF-HD. (© 2021 International Society of Nephrology. Published by Elsevier Inc.) |
| Databáze: | MEDLINE |
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