Abstract:

Patients receiving maintenance hemodialysis have a substantial burden of arrhythmias, which are closely associated with sudden cardiac death and other adverse cardiovascular events. Recurrent changes in electrolytes, volume status, and hemodynamics during and between dialysis sessions may result in distinct dialysis-cycle-related temporal patterns of different arrhythmias. With the increasing use of long-term continuous cardiac rhythm monitoring, understanding of bradyarrhythmias, asystole, subclinical atrial fibrillation, and peri-dialytic arrhythmic events has continued to improve. Research has also gradually expanded to potential mechanisms and management strategies involving potassium and other electrolytes, volume control, anticoagulation, and device therapy. This review summarizes the temporal characteristics, pathophysiological basis, monitoring approaches, and advances in the management of arrhythmias in patients undergoing hemodialysis, to inform clinical risk stratification and individualized management.

Key words:

hemodialysis, arrhythmia, dialysis cycle, sudden cardiac death, continuous cardiac rhythm monitoring