Cardiac Arrhythmias in Patients on Maintenance Hemodialysis

Abstract

Patients (17) on maintenance hemodialysis were monitored for cardiac arrhythmias using ambulatory ECG recording. Atrioventricular dissocation was found in a patient with an elevated serum digoxin concentration, intradialytic supraventricular tachycardia were present in a 2nd patient during acute uremia pericarditis prior to the study. Ventricular premature beats (VPD) were absent or of low grade (occasional/uniform) in 14 patients and did not incease on dialysis. Three patients had potentially dangerous VPB of higher grades (multiform, salvos or R on T) which R, TNA occurred on or after dialysis in 2. Of these 3 patients, 2 were overdigitalized, and 2 had severe cardiac disease (amyloid, old myocardial infarction). Several other risk factors (age, hypertension, cardiac hypertrophy, smoking, hyperlipidemia, electrolyte changes) did not seem to be importance for VPB. In these patients on maintenance hemodialysis, potentially dangerous VPB were rare and occurred mainly during or after dialysis in patients with preexisting heart disease and/or digitalization.