Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis

Abstract

Objective: Atrial fibrillation (AF) is one of the most common and cumulatively important cardiac arrhythmias. Prevalence of AF is much higher in patients with chronic kidney disease (may be up to 27%). We aimed to study the prevalence and clinical features of AF in hemodialysis centers.Materials and Methods: Patients who had been under chronic in-center hemodialysis for at least 6 months and were ≥18 years of age were included in this cross-sectional study conducted at five hemodialysis centers across İstanbul between May 2017 and July 2017. Medical history, clinical (including medications and echocardiography), and laboratory data were obtained using a standardized study form. Results: The data of 632 prevalent patients undergoing in-center hemodialysis (mean age 62.7±13.9 years, males 350 and females 282) were included in the analysis. AF was present in 92 (14.5%) of the patients. The prevalence of AF was lowest in patients <55 years of age and showed an increasing trend with age. While age, coronary artery disease, heart failure, and cerebrovascular events were associated with the presence of AF; left ventricular hypertrophy, diabetes and hypertension were not. Overall, 78% of patients with AF were using either single or a combination of antithrombotic agents. Less than 10% of AF patients were receiving warfarin. The rates of antiplatelet agents and warfarin use were not different between patients with a CHA2DS2-VASc score of ≥2 or less.Conclusion: AF is highly prevalent in patients undergoing hemodialysis, and warfarin was used in nearly 5% of the patients with AF undergoing hemodialysis in this study, which suggests that the current knowledge is unconvincing to proceed for the treatment with anticoagulation. Further studies are needed to guide the management for prevention of strokes in patients with AF undergoing dialysis.