The prevalence of atrial fibrillation in dialysis patients is higher than previously thought, researchers say. The most common form of cardiac arrhythmia, atrial fibrillation (afib) is a major risk factor for strokes. Atrial fibrillation causes an irregular, sometimes faster heartbeat that prevents the heart from working efficiently and increases the risk of stroke. In an ongoing study currently being performed by the Medical University of Vienna, researchers found that 26.5 percent of hemodialysis patients suffered from atrial fibrillation, as opposed to the original estimate of 10–15 percent.
To conduct the study, scientists examined a group of 626 patients out of Vienna’s approximately 850 citizens receiving dialysis treatments, allowing them to get a good representative sample. They also conducted direct patient surveys and analyzed individual patient records in order to obtain more accurate results.
The study has found that atrial fibrillation is more common with age and is more prevalent in male subjects. Lead author of the study Oliver Konigsbrugge noted that “despite the risk of stroke associated with atrial fibrillation, only half of those affected are being treated with an anticoagulant.” While anticoagulants can be used to treat those with atrial fibrillation, patients receiving dialysis are at a greater risk for bleeding and blood loss, making blood thinners and anticoagulants dangerous. In fact, many of the newer medications available for treating atrial fibrillation have not been approved for those undergoing hemodialysis, as the risk of blood loss is too great.
The dilemma facing researchers now is whether the high risk of stroke in dialysis patients who have atrial fibrillation outweighs the potential for significant blood loss caused by many of the drugs used to treat afib. Head of the 3rd Medical Department of Danube Hospital, Renate Klauser-Braun addressed this problem, “The available treatments for preventing the complications of atrial fibrillation, especially strokes, in people with healthy kidneys are contraindicated for patients on dialysis or are problematic, because of the complex clinical picture, so that further treatment and antithrombotic prophylaxis must be decided on a case-by-case basis.” While the study has shown a large percentage of the Viennese population undergoing hemodialysis is also effected by atrial fibrillation, it is important to note that there is no one way to treat the issue.