الفهرس 
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Abstract
Atrial fibrillation (AF) is the most common arrhythmia in the general population; its prevalence increases with age and generally is associated with increased mortality.
Cardiovascular disease is common in ESRD patients. At the same time, renal disease, even at the earliest stages, is a cardiovascular risk factor.
Despite major advances in dialysis technology, mortality is still high in patients with end-stage renal disease. Mortality is seen 10 to 15 times more often than it is in age- and sex-matched normal populations, and about half of the deaths are due to cardiovascular diseases.
AF may be favoured by myocardial modifications that are common in HD patients and that lead to structural and electrical remodelling, with a decrease in atrial effective refractory period and conduction velocity. Moreover, the sharp transmembrane ionic movements occurring during HD sessions may favor the onset of the arrhythmia.
Early diagnosis of AF would not only allow the early initiation of rate and rhythm control therapy, but could also help to prevent AF-related complications, for example, by timely initiation of antithrombotic therapy
The aim of this study was to determine the prevalence of atrial fibrillation in long-term haemodialysis patients and to identify clinical and echocardiographic risk factors.
The present study included 179 patients receiving regular haemodialysis in Ain Shams University hospitals. All patients were subjected to full history, detailed physical examinations, 12 lead ECG in last 2 hours of dialysis session and during interdialytic days, echocardiographic examination for patients who are diagnosed as having AF by ECG and for a control group of same number, and laboratory investigations in form of (CBC, serum creatinine, BUN, Na+, K+, Ca+2, PO4-, Albumin, PTH).
The results showed that the prevalence of atrial fibrillation was 15 % in the present study.
There was a highly significant statistical difference between the age and AF and there was no significant statistical difference between AF and the duration of dialysis, gender and BMI.
There was no significant statistical difference between the AF and FBS, calcium, phosphate, Hgb, PTH and serum albumin levels. Also Na, K, cr, BUN levels before and after haemodialysis had statistically insignificant difference on AF prevalence.
In the present study, both right and left atrial sizes were greater in patients with atrial fibrillation, but the difference in left atrial sizes among groups did not reach statistical significance.
In univariate analysis, we found that age,hypertension CAD,left ventricular systolic dysfunction, right atrial diameter RVSP and mitral and/or aortic calcification were significantly more frequent in patients with atrial fibrillation as dependent risk factors.
However, in multivariate analysis only age and right atrial diameter were found to be independent predictors of atrial fibrillation in patients with end-stage renal disease. This may result from the relatively small number of the study group.
In conclusion, the present data indicate that atrial fibrillation is a frequent arrhythmia in patients with chronic renal failure and the most frequently encountered form is permanent atrial fibrillation. In this patient group, age and right atrial diameter are independent factors for determination of the risk of development of atrial fibrillation.