Subclinical Atrial Fibrillation Screening in Dialytic Chronic Kidney Disease Patients Using Portable Device.

Area of Science:

• Nephrology
• Cardiology
• Medical Devices

Background:

• Hemodialysis (HD) patients exhibit elevated cardiovascular risks, including a higher prevalence of arrhythmias like atrial fibrillation (AF).
• Atrial fibrillation is a significant independent risk factor for mortality and thromboembolic events in dialysis patients.
• Accurate AF prevalence data is crucial for managing cardiovascular health in HD populations, yet screening remains challenging.

Purpose of the Study:

• To implement and assess a portable device for screening atrial fibrillation (AF) in hemodialysis patients.
• To evaluate the diagnostic performance of the portable screening device in this specific patient group.

Main Methods:

• AF screening was conducted on 388 hemodialysis patients during dialysis sessions using the portable MyDiagnostick® device.
• Data on patient demographics, clinical factors, and dialysis parameters were collected for association analysis.
• Statistical significance was determined using a p-value threshold of less than 0.05.

Main Results:

• The screening identified 16 patients (4.1%) with potential AF, and 7 (1.8%) were confirmed by electrocardiogram.
• Factors associated with positive AF screening included male sex, older age, pre-existing ECG abnormalities, elevated potassium, lower systolic blood pressure, and stable angina.
• The device demonstrated high diagnostic accuracy with 100% sensitivity and 91.74% specificity for AF detection.

Conclusions:

• The portable device is a practical tool for AF screening in hemodialysis patients, offering high sensitivity and an excellent negative predictive value.
• Subclinical atrial fibrillation is highly prevalent in this population and may be frequently underestimated.
• This technology offers a pioneering approach to improving cardiovascular risk assessment in hemodialysis patients.