Dialysis Increasing the Incidence of Atrial Fibrillation

By: Alere Staff
Publication Date: Fri, 02/01/2013

People undergoing dialysis have an increased risk of developing a common heart rhythm disturbance called atrial fibrillation; which is a risk factor for stroke. A recent study, Trends in the Incidence of Atrial Fibrillation in Older Patients Initiating Dialysis in the United States, found an 11% increase in atrial fibrillation soon after starting dialysis. During the study years of 1995-2008, there was also a 22% reduction in mortality including stroke.1

The study included 250,000 patients aged 67 years or older starting chronic dialysis. Chronic dialysis was described as typically 3 times per week. The incidence rate of atrial fibrillation was reported to be 29%.1

Warfarin (or brand of warfarin such as Coumadin®) is commonly used to prevent stroke in people with atrial fibrillation. The study investigators suggested that higher rates of warfarin use may have been responsible for lower rates of death but they did not have the data to prove it.1

Previous smaller studies have also shown an increase in atrial fibrillation in people on dialysis.2, 3, 4 However, the authors of those studies stated that the increase in atrial fibrillation was largely associated with those patients who previously had risk factors for atrial fibrillation.

References: 

  1. Wolfgang C. Winkelmayer. 2012. Trends in the Incidence of Atrial Fibrillation in Older Patients Initiating Dialysis in the United States. Circulation. 112.099606.
  2. Zebe H: Atrial fibrillation in dialysis patients. Nephrol Dial Transplant 2000, 15:765-8.
  3. Stroke Prevention in Atrial Fibrillation investigators: Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. Lancet 1996, 348:633-8.
  4. Abbott K., et al. Atrial fibrillation in chronic dialysis patients in the United states: risk factors for hospitalization and mortality. BMC Nephrology 2003. doi:10.1186/1471-2369-4-1. 

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