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Nephrol Dial Transplant (2000) 15: 765-768
© 2000 European Renal Association-European Dialysis and Transplant Association

Invited Comment

Atrial fibrillation in dialysis patients

Horst Zebe

Epidemiology and classification of atrial fibrillation

Atrial fibrillation is regarded as the most frequent supraventricular cardiac arrhythmia. Its incidence in the adult population is 0.5%. The probability of developing atrial fibrillation rises with increasing age. The Framingham study reports an incidence of 0.4% for persons under 30 years, whereas atrial fibrillation is observed in 2–4% of persons aged over 60 years.

Secondary forms resulting from cardiac and extracardiac diseases must be distinguished from the rarer primary (idiopathic) forms of atrial fibrillation without concomitant cardiac disease (lone atrial fibrillation) [1].

Without consideration of the aetiology and for reasons of practicability, atrial fibrillation is subdivided clinically into:

(i) Paroxysmal atrial fibrillation, which occurs episodically and converts spontaneously into sinus rhythm within 48 h at the most.
(ii) Persistent atrial fibrillation, which is sustained for longer than 48 h, but which continues to be convertible into sinus rhythm.
(iii) Permanent atrial fibrillation, which can no longer be . . . [Full Text of this Article]

Clinical features

Haemodynamics

Electrophysiology

Prognosis

Criteria for therapy

(i) Non-drug treatment
(ii) Pharmacotherapy
Antiarrhythmic class 1A and class 1C agents

Class 1A
Quinidine
Disopyramide
Class 1C
Propafenone
Other class 1C drugs
Class II
Propranolol and metaprolol
Esmolol
Class III
Sotalol
Amiodarone
Class IV drugs
Verapamil
Class V drugs
Digitalis
Other measures
Notes

References


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