Types of Arrhythmias and the risk of sudden cardiac death in dialysis patients: A Systematic Review and Meta-analysis

Background Patients on long-term dialysis therapy due to ESRD tend to have a high mortality rate, predominantly due to cardiovascular complications, which is associated with an increased risk of arrhythmias compared to the general population. Arrhythmia has been firmly identified as the primary cause of sudden death during dialysis, as studies have shown a correlation between the timing of dialysis sessions and episodes of sudden death, as well as relationships with serum or dialysate electrotype concentrations. It also associated with a six-fold increased risk of developing ventricular fibrillation following a first myocardial infarction. Methods This systematic review and meta-analysis followed the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The reviewers searched the Cochrane Library, MEDLINE, Europe PMC, and Google Scholar Databases for relevant data sources. We included only randomized controlled trials and cohort studies published in English. A quantitative analysis (meta-analysis) was conducted using Review Manager version 5.4 (RevMan 5.4; The Nordic Cochrane Center, The Cochrane Collaboration, 2014). Results The initial database search yielded 547 studies, of which 213 duplicates were excluded. The title, abstract, and full-text screening excluded 247 studies, and the final total included 13 studies reporting the incidence of SCD mortality in this meta-analysis. Conclusion SCD remains a major public health concern, particularly in patients undergoing dialysis. Meta-analysis results show that bradyarrhythmia emerges as a common type of arrhythmia leading to SCD; however, other types of arrhythmias should also be considered.