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Cardiovascular implantable electronic devices and native arteriovenous fistula in hemodialysis patients: novel perspectives

  • Nephrology - Review
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Abstract

The benefits from cardiovascular implantable electronic devices (CIED) implantation in hemodialysis (HD) patients are still far to be thoroughly defined, especially on primary prevention. In addition, CIED placement is not a risk-free procedure, because it could be followed by a not negligible burden of complications that could compromise the health and the vascular access of HD patients. In fact, the arteriovenous fistula (AVF) dysfunction following CIED implantation is usually due to a hemodynamically significant alteration of blood flow. This condition could lead to a potential decrease of dialysis efficacy and a raised risk of thrombosis of both the central vein and the efferent vein of the AVF.

The pathological pathway that leads to AVF dysfunction after CIED implantation may involve the irritating actions of the CIED and their leads to the vascular wall in HD patients that are more prone to show previous vascular diseases.

The aim of this review is to focus the physiopathology of the CIED-induced AVF dysfunction, the current treatment strategies and the novel perspectives that could be taken into consideration and offered to the HD population to preserve both their AVF and their quality of life.

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Acknowledgements

All the authors disclose any conflict of interest and any funding for the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Nephrology, Dialysis and Renal Transplantation, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore 3, 20162, Milan, Italy

    Leonardo Spatola

  2. Division of Nephrology and Dialysis, ASST Monza, Desio and San Gerardo Hospital, Milan, Italy

    Rodolfo Fernando Rivera

  3. Division of Cardiology, West Vicenza General Hospitals, Arzignano, Vicenza, Italy

    Giacomo Mugnai

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  1. Leonardo Spatola
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  2. Rodolfo Fernando Rivera
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  3. Giacomo Mugnai
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Spatola, L., Rivera, R.F. & Mugnai, G. Cardiovascular implantable electronic devices and native arteriovenous fistula in hemodialysis patients: novel perspectives. Int Urol Nephrol 53, 2541–2548 (2021). https://doi.org/10.1007/s11255-021-02830-w

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