Implantable Loop Recorder in Hemodialysis Patients
Implantable Loop Recorder in Hemodialysis Patients
The purpose of this study is to use implantable loop recorder (ILR) in patients under chronic
 hemodialysis to record arrhythmias and conduction disorders and correlate them with
 hemodialysis parameters.
Primary cause of death in patients under chronic hemodialysis is Sudden Cardiac Death (SCD)
 (25% of all cause mortality). SCD is mainly due to cardiac arrhythmias (conduction
 disturbances or ventricular arrhythmias). These cardiac arrhythmias are highly sensitive to
 hydro-electrolytic disorders which are extremely frequent in patients under hemodialysis. In
 addition, other conditions leading to cardiac arrhythmias are frequent in this population
 such as ischemic myocardiopathy or dilated myocardiopathy. However, so far, little is known
 about the occurrence of arrhythmias because of studies using only standard Holter monitoring
 (24 to 48 hours monitoring at best).

 The investigators sought to evaluate the incidence of cardiac arrhythmias by using an
 implantable loop recorder (ILR)(Reveal XT, Medtronic) that allows continuous rhythm
 monitoring for 24 months. This ILR will be implanted under local anesthesia.

 Clinical follow-up will be performed during hemodialysis and rhythm management will be
 performed automatically using a remote-monitoring system (Carelink, Medtronic).
 Pre-programmed alerts (conduction disturbances, supra-ventricular arrhythmias or ventricular
 arrhythmias) recorded by the ILR will be sent automatically on a daily basis in our center.
 These data will be analyzed during week days from 9AM to 5PM. They will be reviewed by an
 electrophysiologists and depending on the potential lethality, the patients will be called
 and ask to come to the emergency room in case of high risk or the nephrologist will be
 contacted and he will see the patients during the next hemodialysis in case of on vital
 event.
Inclusion Criteria:

 -  Patients under chronic hemodialysis

 -  Age between 45 and 80 yo

 -  written informed consent

 -  affiliated to the French Social Security system

 Exclusion Criteria:

 -  Pace-maker or Implantable Cardioverter Defibrillator

 -  Active infection

 -  Neoplasia or any pathology with a life expectancy <12 months

 -  Cachexia

 -  Patient with restricted civic rights by law