[Incidence of atrial fibrillation in hemodialysis patients. A prospective long-term follow-up study].
OBJECTIVE
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.


METHODS
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.


RESULTS
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 > or =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 six thromboembolic episodes in a follow-up period of 23.6 (21.4) months (i.e., 15 episodes per 100 patient-years), compared with three episodes per 100 patient-years in the SR group (relative risk=5.2; 95% CI, 2.1-12.4).


CONCLUSIONS
Each year, three in every 100 patients in our dialysis unit developed AF. The occurrence of AF increased the risk of a thromboembolic complication five-fold. The use of anticoagulant treatment in these patients should be carefully evaluated.
Vázquez-Ruiz de Castroviejoa
Eduardo
E
Servicio de Cardiología, Complejo Hospitalario de Jaén, Jaén, España. vazquez89@arrakis.es
Sánchez-Perales
Carmen
C
Lozano-Cabezas
Cristóbal
C
García-Cortés
María José
MJ
Guzmán-Herrera
Manuel
M
Borrego-Utiel
Francisco
F
López-López
Juana
J
Pérez-Bañasco
Vicente
V
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors