Role of Hemodialysis in Atrial Fibrillation Onset: Preliminary Results from a Combined Computational and Experimental Analysis

In end stage renal disease (ESRD) patients atrial fibrillation (AF) prevalence is extremely high and the hemodialysis (HD) session can trigger paroxysmal AF episodes. We aimed to highlight the role of hemodialysis on the AF onset through a combined experimental and computational study. In l1 ESRD patients the effects of hemodialysis on P wave duration, which reflects the intra-atrial conduction velocity, and on AP characteristics were evaluated. The Courtemanche model of human atrial myocyte was used to simulate the effects of dialysis on AP. The P wave duration slightly but systematically increased after dialysis. Coherently, the model-based analysis indicated a similar reduction in the maximum AP upstroke velocity. The simulated action potential duration) was also reduced at the end of dialysis These results indicate slowing of atrial conduction and shortening of the refractory period as possible proarrhythmic consequences of the hemodialysis session