XXIV. Ulusal Kardiyoloji Kongresi XXIV. National Congress of Cardiology

1. Gün 26 Ekim 2008, Pazar Day 1 October 26, 2008 Sunday

SÖZLÜ BİLDİRİLER / ORAL PRESENTATIONS Düşmanımızı tanıyalım: Farklı yönleri ile atriyal fibrilasyon

Know your enemy: Different aspects of atrial fibrillation

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Kronik böbrek yetmezliği nedeniyle diyalize giren hastalarda atriyal fibrilasyon varlığının sağkalım üzerine etkileri

Prognostic significance of atrial fibrillation in patients with end-stage renal disease

Ezgi Polat,1 Pınar Şişman,2 İlyas Atar,1 Burak Sayın,2 Şevket Balta,1 Didem Konaş,1 Alp Aydınalp,1 Cağatay Ertan,1 Hüseyin Bozbaş,1 Nurhan Özdemir,2 Haldun Müderrisoğlu,1 Bülent Özin1

Ezgi Polat,1 Pınar Şişman,2 İlyas Atar,1 Burak Sayın,2 Şevket Balta,1 Didem Konaş,1 Alp Aydınalp,1 Cağatay Ertan,1 Hüseyin Bozbaş,1 Nurhan Özdemir,2 Haldun Müderrisoğlu,1 Bülent Özin1

Başkent Üniversitesi Tıp Fakültesi 1Kardiyoloji Anabilim Dalı, 2İç Hastalıkları Anabilim Dalı, Ankara

Department of 1Cardiology and 2Internal Medicine, Medicine Faculty of Başkent University, Ankara

Amaç: Kronik böbrek yetmezliği (KBY) olan hastalarda atriyal fibrilasyonun (AF) prognoz üzerine etkisi ile ilgili tartışmalı bilgiler mevcuttur. Bu çalışmada KBY nedeniyle diyaliz tedavisi alan bireylerde AF varlığının ölüm üzerine etkisi incelendi.

Karar: Atriyal fibrilasyon KBY hastalarında sık görülen bir ritm bozukluğudur. Bizim hasta grubumuzda AF varlığı ölüm riskini artırmakla birlikte ölümün bağımsız bir belirleyicisi değildir.

Background: There are conflicting data about the prognostic significance of atrial fibrillation (AF) in patients end-stage renal disease (ESRD) patients ongoing hemodialysis. In this study, we aimed to evaluate the relationship between AF and mortality in ESRD patients ongoing hemodialysis. Methods: Two hundred seventy-five end-stage renal disease patients who in a hemodialysis program for at least 4 months were included in the study. All patients were evaluated for cardiac risk factors and arrhythmias. 267 patients included the study and followed up for 5 years. Eight patients excluded. Cardiovascular events, AF, embolic events, hospitalization and death were all recorded. The patient data analyzed to determine the factors predictive for mortality. Results: 275 patients (108 females and 167 males) with a mean age is 49±16 were included the study. Twenty-eight (10.5%) patients had AF, 8 of the patients had permanent or persistent atrial fibrillation, and 20 had paroxysmal atrial fibrillation. In five years follow up 17 patients were diagnosed to have new onset AF. During 5 years; sixty-four patients were died from cardiovascular reason (16 patients, 6%), infection disease (39 patients, 14.6%), major bleeding (1 patients, 0.4%) and unknown reasons or sudden cardiac death at their home (7 patients, 2.6%). In univariate analysis, age (p20% increase or decrease in measures from baseline to peak pacing rates. Tissue tracking showed an increase in LVsd in 11 pts (46%), a decrease in 12 pts (50%) and no change in 1 pts (4%). There was a wide range of discordance in LVsd evaluated by 6 TSI parameters in terms of dynamic response to acceleration (Table 1). With acceleration, decrease in LVsd was more frequent than increase in LVsd, anf only 8 pts (34%) showed a concordance between LVsd measures assessed by 6 TSI parameters. Dynamic change in LVsd showed no correlation with LVEDV and LVESV. However, pts with decreased LVsd showed a more significant increase in CO (p