arrhythmias in HD patients

Q:  The most common cardiac arrhythmia in patients with end-stage kidney disease (ESRD) who are on hemodialysis(HD) is? (select one)

A) Ventricular tachycardia/fibrillation (VT/VF)

B) asystole

Answer: A

A literature search showed only a small study of 75 patients in this regard. These patients were analyzed while wearing a cardioverter-defibrillator (WCD). Almost 80% of patients experienced VT/VF and about 20% has asystole. 

ESRD patients who are on HD may not be a candidate for an implantable cardiac defibrillator (ICD) due to their inherent issues of infection, bleeding, and vasculopathy. These patients (if not a candidate for ICD), may need to apply a WCD jacket to their chest. 

It saves 7 out of 10 patients in the early 24 hours of arrhythmia.

#cardiology

#nephrology

Reference:

Wan C, Herzog CA, Zareba W, Szymkiewicz SJ. Sudden cardiac arrest in hemodialysis patients with wearable cardioverter defibrillator. Ann Noninvasive Electrocardiol 2014; 19:247.