Abstract: FR-PO367
Temporal Changes in Cardiac Conduction Disorders in Patients with ESKD on Long-Term Hemodialysis
Session Information
- Hypertension, CVD, and the Kidneys: Epidemiology
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Thomas, Taniya, Albany Medical College, Albany, New York, United States
- Djanie, Thermutis, Albany Medical College, Albany, New York, United States
- Daghstani, Omar, Albany Medical Center, Albany, New York, United States
- Hongalgi, Krishnakumar D., Albany Medical Center, Albany, New York, United States
- Torosoff, Mikhail, Albany Medical Center, Albany, New York, United States
Background
Cardiac amyloidosis is a known complication of end stage kidney disease (ESKD) which manifests with conduction abnormalities, including atrioventricular (AV) blocks, and requires atrial and/or ventricular pacing. The prevalence and temporal changes in conduction disorders in ESKD patients has not been well investigated.
Methods
We conducted a retrospective, IRB approved study of 166 consecutive ESKD patients who underwent arteriovenous (AV) fistula placement between 2006-2023. Electrocardiographic features historically associated with cardiac amyloidosis, including AV blocks and paced rhythms, were examined on pre- and post-AV fistula placement electrocardiograms (ECG).
Results
Mean age was 59.7 +/- 14.7 years old, 41.0% were females, with body mass index (BMI) of 28.1 +/- 6.6, and histories of hypertension in 92.8%, coronary artery disease (CAD) in 48.2%, atrial fibrillation/flutter in 34.4%, diabetes mellitus in 60.8%, chronic obstructive pulmonary disease in 29.5%, coronary artery bypass grafting in 15.7%, and congestive heart failure in 51.2% of patients. The mean duration of hemodialysis (HD) was 57 +/- 50 months. The mean interval between ECG evaluations was 35+/- 28 months.
At baseline, 13.9% of patients were noted to have AV blocks or require atrial or ventricular pacing. Advanced age (p=0.03), histories of CAD (p=0.03), and atrial fibrillation/flutter (p=0.02) were strongly associated with conduction abnormalities. Prevalence of AV blocks and the need for pacing significantly increased on the follow-up evaluation, affecting 17.5% of the study cohort (p<0.0001). However, at this point, traditional risk factors for conduction abnormalities were not associated with the need for pacing.
Conclusion
The prevalence of AV blocks and paced rhythms increase overtime in patients with ESKD on long-term HD. These abnormalities are initially more common in ESKD patients with traditional risk factors for cardiac conduction disorders. However, there appears to be no association between traditional risk factors and the prevalence of AV blocks and paced rhythms in ESKD patients on long-term HD post-AV fistula placement. Therefore, routine monitoring for conduction delays is imperative in all ESKD patients on HD.