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. 2017 Oct 10;18(1):309.
doi: 10.1186/s12882-017-0740-1.

Frequency of arrhythmia symptoms and acceptability of implantable cardiac monitors in Hemodialysis patients

Naya El Hage  1 , Bernard G Jaar  2   3   4 , Alan Cheng  5 , Chloe Knight  2 , Elena Blasco-Colmenares  6 , Luis Gimenez  2   4 , Eliseo Guallar  3   6   7 , Tariq Shafi  8   9   10
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Frequency of arrhythmia symptoms and acceptability of implantable cardiac monitors in Hemodialysis patients

Naya El Hage et al. BMC Nephrol. .

Abstract

Background: Arrhythmia-related complications and sudden death are common in dialysis patients. However, routine cardiac monitoring has so far not been feasible. Miniaturization of implantable cardiac monitors offers a new paradigm for detection and management of arrhythmias in dialysis patients. The goal of our study was to determine the frequency of arrhythmia-related symptoms in hemodialysis patients and to assess their willingness to undergo implantation of a cardiac monitor.

Methods: We conducted a survey of in-center hemodialysis patients at a hemodialysis clinic in Baltimore, Maryland. We assessed the frequency of arrhythmia-related symptoms and willingness to undergo placement of an implantable cardiac monitor (LINQ, Medtronic Inc.).

Results: Forty six patients completed the survey. The mean age of the survey respondents was 59 years and 65% were male. Symptoms were common with 74% (n = 34) of participants reporting at least one arrhythmia-related symptom and many [22% (n = 10)] had all 3 symptoms. Among the patients with symptoms, 57% (n = 26) reported "heart skipping beats, flopping in chest or beating very hard," 61% (n = 28) reported "heart racing (palpitations)," and 37% (n = 17) reported feeling that they "passed out or almost passed out." The majority of the patients felt that the timing of the symptoms was unrelated to dialysis treatments. The acceptability of the monitoring device implantation was high, with 59% (n = 20) of patients with symptoms and 50% (n = 6) of patients without symptoms willing to consider it. The main reason for not considering the device was not wanting to have an implanted device.

Conclusion: The prevalence of arrhythmia-related symptoms is high in hemodialysis patients and the majority would consider an implantable cardiac monitor if recommended by their physicians. Routine implantation of cardiac monitoring devices to manage arrhythmias in dialysis patients may be feasible and will provide further insights on the leading causes of morbidity and mortality in dialysis patients.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Johns Hopkins Medicine Institutional Review Board (IRB) with verbal consent (IRB00054481).

Consent for publication

Not applicable. No individual details.

Competing interests

Dr. Alan Cheng is an employee of Medtronic, manufacturer of the LINQ device, but was not employed by Medtronic when the study was conducted. Medtronic or its employees had no involvement in study design, data collection or data analysis. Dr. Bernard Jaar is a Section Editor and Dr. Tariq Shafi is an Associate Editor for BMC Nephrology.

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