Cardiac Arrhythmias in Patients with End Stage Renal Disease (ESRD) on Hemodialysis; Recent Update and Brief Literature Review

Cardiovascular diseases remains one of the leading causes of mortality worldwide, and causes more than one millions deaths annually in the United States alone. Patients with chronic kidney disease (CKD) are predisposed to different types of heart rhythm abnormalities including but not limited to atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. Both cardiovascular diseases and chronic kidney disease (CKD) may cause various variations in the cardiovascular system, autonomic nervous system, and various electrolytes abnormalities that open the door for the occurrence of multiple cardiac arrhythmias. Various pathophysiological mechanisms have been suggested in describing the correlation of cardiac arrhythmias in CKD patients. Despite the substantial progress in the management of chronic kidney disease, cardiovascular complications still highly dominant in CKD patient. Thus, reducing mortality from cardiovascular disease and sudden cardiac death in dialysis is a global health challenge. Management of cardiac arrhythmias includes the use of antiarrhythmic drugs, in addition to the use of catheter ablation and cardiac implantable electronic devices. The present review addresses the correlation between chronic kidney disease and different cardiac arrhythmias, the different pathophysiological mechanisms explaining the high risk of arrhythmias in CKD patients, the diagnostic tools used to identify arrhythmias, and the rule of subcutaneous defibrillators in preventing sudden cardiac death in dialysis patients