Key result
Implantable loop recorder monitoring proves safe in hemodialysis, with home nocturnal dialysis linked to arrhythmia resolution.
Why the study?
Patients on hemodialysis have an increased risk of sudden cardiac death and cardiac arrhythmia burden from large fluid and electrolyte shifts, which home nocturnal hemodialysis may reduce. This study evaluated the safety and feasibility of prolonged cardiac monitoring in patients converting from conventional to home nocturnal hemodialysis.
Does conversion from conventional intermittent hemodialysis to home nocturnal hemodialysis with implantable loop recorder monitoring safely and feasibly monitor and reduce cardiac arrhythmic events in low-cardiac-risk hemodialysis patients?
Observational (n=10)
No
Does conversion from conventional intermittent hemodialysis to home nocturnal hemodialysis with implantable loop recorder monitoring safely and feasibly monitor and reduce cardiac arrhythmic events in low-cardiac-risk hemodialysis patients?
This pilot study demonstrates that prolonged cardiac arrhythmia monitoring using an implantable loop recorder is safe and feasible in stable patients converting from conventional to home nocturnal hemodialysis.
Answers are grounded in this paper and cite their sources.
Safety and feasibility of prolonged monitoring support arrhythmia assessment during nocturnal hemodialysis transition; leaves open clinical impact on sudden death risk.
INTRODUCTION: Patients on hemodialysis have an increased risk of sudden cardiac death and an increased cardiac arrhythmia burden due to large fluid and electrolyte shifts, especially during the long inter-dialytic period. Arrhythmia burden may be decreased on home nocturnal hemodialysis due to prolonged fluid removal and clearance. This study examined the safety and feasibility of prolonged cardiac monitoring in patients who were converting from conventional hemodialysis (12 h) to home nocturnal hemodialysis (30+ h). METHODS: Patients from a single center in Toronto, Ontario, Canada with a low cardiac risk profile, who were eligible to perform hemodialysis at home, were enrolled. Participants underwent the insertion of an implantable loop recorder and cardiac arrhythmia were monitored during conventional hemodialysis, and for 1 year after conversion to home nocturnal hemodialysis. FINDINGS: Ten participants completed the study. The average ultrafiltration rate per session during conventional hemodialysis was 6.87 mL/h/kg, and the average cardiac ejection fraction was 52.6%. There were no adverse effects associated with implantable loop recorder implantation, usage, or removal. One participant recorded three sinus bradycardia and two sinus pause events during conventional hemodialysis that resolved after conversion to home nocturnal hemodialysis. All other participants did not experience any arrhythmic events before or after conversion to home nocturnal hemodialysis. DISCUSSION: Our pilot study demonstrated a safe and feasible protocol for prolonged monitoring of cardiac arrhythmia in a stable population undergoing conversion from conventional to home nocturnal hemodialysis. Due to the small sample size, future work is required to delineate the full effect of home nocturnal hemodialysis on cardiac arrhythmia burden in patients with increased cardiac comorbidities.
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Ye et al. (2026) conducted an observational in End-stage renal disease on hemodialysis (n=10). Implantable loop recorder monitoring and conversion to home nocturnal hemodialysis (30+ h) vs. Conventional intermittent hemodialysis (12 h) was evaluated on Safety and feasibility of implantable loop recorder monitoring and cardiac arrhythmic events. Implantable loop recorder monitoring caused 0% adverse events, and conversion to home nocturnal hemodialysis resolved arrhythmias seen in 1 of 10 patients.
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