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European Heart Journal Advance Access originally published online on May 22, 2009
European Heart Journal 2009 30(13):1559-1564; doi:10.1093/eurheartj/ehp185
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

The current status of interventions aiming at reducing sudden cardiac death in dialysis patients

Mihály K. de Bie1, Bastiaan van Dam2, André Gaasbeek3, Marjolijn van Buren4, Lieselot van Erven1, Jeroen J. Bax1, Martin J. Schalij1, Ton J. Rabelink3 and J. Wouter Jukema1,*

1 Department of Cardiology C5-P, Leiden University Medical Center, PO Box 9600 2300, RC Leiden, The Netherlands
2 Department of Nephrology, Medical Center Alkmaar, The Netherlands
3 Department of Nephrology, Leiden University Medical Center, The Netherlands
4 Department of Nephrology, HAGA Hospital, The Netherlands

Received 29 October 2008; revised 17 March 2009; accepted 21 April 2009; online publish-ahead-of-print 22 May 2009.

* Corresponding author. Tel: +31 71 526 2020, Fax: +31 71 526 6809, Email: j.w.jukema{at}lumc.nl

Mortality in dialysis patients is extremely high, with an annual death rate of ~23%. Sudden cardiac death (SCD) is the single largest cause of death in dialysis patients accounting for ~60% of all cardiac deaths and 25% of all-cause mortality. Interventions aiming at reducing cardiovascular mortality, especially SCD, in dialysis patients are therefore extremely important and clinically highly relevant. The purpose of this review is to give an outline of the epidemiology of SCD in dialysis patients and to provide a comprehensive overview of several interventional strategies (medical therapies, changing dialysis modality, and revascularization). Furthermore, it will discuss the current knowledge regarding the value of preventive implantable cardioverter defibrillator implantation and address future implications of the interventional strategies mentioned.

Key Words: Sudden cardiac death • Dialysis • Implantable cardioverter defibrillator therapy • Ischaemic heart disease • Left ventricular hypertrophy


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