Monitors identify frequent preclinical cardiac arrythmias in patients with CKD, type 2 diabetes
Mobile cardiac telemetry monitors detected high rates of preclinical cardiac arrythmias in patients with chronic kidney disease and type 2 diabetes, according to a published study. Monitoring these patients for such abnormalities may help prevent clinically significant cardiovascular events, such as sudden cardiac death.
“Cardiac rhythm abnormalities, including atrial fibrillation and ventricular arrythmias, are more prevalent in patients with CKD compared with the general population and lead to poor clinical outcomes such as higher rates of death, including sudden cardiac death,” Nazem Akoum, MD, MS, of the University of Washington in Seattle, and colleagues wrote. “Some studies have been conducted to assess preclinical arrhythmic burden in patients with ESKD requiring hemodialysis, using implantable cardiac monitors or loop recorders. Although these studies are informative, they have not provided data on the larger, nondialysis-requiring population. With the widespread availability of noninvasive external mobile cardiac telemetry monitors, there is an opportunity to characterize the burden of preclinical cardiac arrythmias in patients with CKD.”
Researchers conducted a prospective observational study of 38 patients with type 2 diabetes and moderate to severe CKD (eGFR between 15 mL/min/1.73m2 to 60 mL/min/1.73m2; mean, 38 mL/min/1.73m2).
All participants underwent ambulatory cardiac monitoring for a minimum of 7 days through use of a device that attached to the chest (mean duration of monitoring per patient, 11.2 days). Arrythmia types considered included supraventricular arrythmias, atrial fibrillation/flutter, conduction abnormalities and ventricular arrythmias.
Researchers found approximately half of the study population experienced significant cardiac arrythmia with an overall mean rate of 88.8 episodes per person-year. Atrial fibrillation was the most common arrythmia, which occurred at a rate of 37.6 per person-year. No participants experienced related symptoms. Researchers also noted that a history of cardiovascular disease was associated with a higher rate of detected arrythmia (rate ratio = 5.87).
“These data suggest that patients with nondialysis-requiring CKD likely have a high burden of subclinical cardiac arrythmias, which in turn may contribute to the high rates of cardiovascular morbidity and mortality in this population,” the researchers wrote. “Further data are needed to determine whether treatment of subclinical cardiac arrythmias reduce cardiovascular complications and improve overall survival in this high-risk CKD population.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.