title: [Incidence of atrial fibrillation in hemodialysis patients. A prospective long-term follow-up study].
abstract: 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.
authors.affiliation: Servicio de Cardiología, Complejo Hospitalario de Jaén, Jaén, España. vazquez89@arrakis.es
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vázquez-Ruiz de Castroviejoa
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez-Perales
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Lozano-Cabezas
authors.forename: María José
authors.initials: MJ
authors.lastname: García-Cortés
authors.forename: Manuel
authors.initials: M
authors.lastname: Guzmán-Herrera
authors.forename: Francisco
authors.initials: F
authors.lastname: Borrego-Utiel
authors.forename: Juana
authors.initials: J
authors.lastname: López-López
authors.forename: Vicente
authors.initials: V
authors.lastname: Pérez-Bañasco
mesh_terms: 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