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2015, Number 3

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Revista Habanera de Ciencias Médicas 2015; 14 (3)

Life-threatening ventricular arrhythmias in hemodialysis patients

Suárez CAM, Otero MJM, Otero SM

Language: Spanish
References: 66
Page: 357-372
PDF size: 156.17 Kb.


ABSTRACT

Introduction: Hemodialysis patients have very high cardiac mortality rates.
Objective: to describe the most important factors implicated in the development of ventricular arrhythmias in patients under hemodialysis treatment.
Material and Methods: a bibliography searching was performed using the selected key words from the Medline database and SciELO available on INFOMED network. In order to find this information, Pubmed and Scielo were used as search engine. 115 scientific articles during last thirsty years were found, 66 of them were referenced in this review.
Development: Hemodialysis is capable of inducing myocardial ischemia and potentially leading to heart failure, precipitating ventricular arrhythmia. A number of factors have been implicated in the genesis of these arrhythmias; however, the arrhythmogenic effect of dialysis has not been uniformly documented. It seems to be that the presenceof preexisting cardiac disease and the interaction of multiple factors that act as trigger, some of which prime for the development of arrhythmias, are likely the most important mechanisms implicated in the pathogenesis of arrhythmias in dialysis patients.
Conclusions: factors assuming greater importance in the development of lifethreatening ventricular arrhythmias in hemodialysis patients may include left ventricular hypertrophy associated with ventricular dysfunction; preexisting coronary artery disease; dialysis-inducedacute cardiac ischemia; abrupt electrolytes concentration shift and sympathetic over activity.


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