The Arrhythmias in End-Stage Renal Disease on Maintenance Haemodialysis: A Cross-Sectional Study

Background Patients with end-stage renal disease (ESRD) on hemodialysis are at high risk for cardiovascular mortality, with arrhythmias being a major contributor. Data on this issue are scarce in low- and middle-income countries like Myanmar. Objectives This study aimed to determine the prevalence of arrhythmias in ESRD patients on maintenance hemodialysis, identify the predictors of these arrhythmias, and explore their clinical implications (short-term clinical outcomes). Methods We conducted a cross-sectional study of 140 adult ESRD patients on maintenance hemodialysis at a single center in Myanmar. All patients underwent 24-hour Holter ECG monitoring. We collected data on demographics, comorbidity, and laboratory and echocardiographic data. Logistic regression was used to identify predictors of arrhythmias. Results The mean age of the patients was 51.1 ± 14.6 years, and 70% were female. The overall prevalence of any arrhythmia was 65.7%. The most common arrhythmias were premature atrial contractions (36.4%) and premature ventricular contractions (31.4%). Atrial fibrillation was present in 7.1% of patients. In multivariate analysis, older age (OR 1.03, 95% CI 1.00–1.06), left ventricular hypertrophy (OR 3.12, 95% CI 1.44–6.76), abnormal left atrial volume index (OR 2.46, 95% CI 1.15–5.27), and higher creatinine levels (OR 1.17, 95% CI 1.00–1.38) were independent predictors of arrhythmias. Patients with arrhythmias had higher rates of hospitalization, emergency visits, and 3-month mortality. Conclusion Arrhythmias are highly prevalent in ESRD patients on hemodialysis in Myanmar and are associated with adverse clinical outcomes. Routine Holter monitoring could be a valuable tool for risk stratification in this high-risk population, particularly for those with echocardiographic evidence of LVH or abnormal LAVI