{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:29:31Z","timestamp":1786472971627,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,6,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Incident atrial fibrillation (AF) is common among adults with kidney failure treated with maintenance dialysis and is associated with poor clinical outcomes. Limited data exist informing treatment of AF among patients on dialysis. We aimed to describe the use of rate\u2010control and antiarrhythmic medications for AF among patients on dialysis and associations of these medication use strategies with stroke and all\u2010cause death.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We evaluated patients on dialysis with incident AF between 2010 and 2017 in the Kaiser Permanente Northern and Southern California integrated health care delivery systems. We characterized time\u2010updated\n              <jats:italic toggle=\"no\">incident<\/jats:italic>\n              receipt of rate\u2010control (\u03b2 blockers, calcium channel blockers, and digoxin) and antiarrhythmic medications from pharmacy databases. We evaluated associations of these therapies with the composite outcome of ischemic stroke and all\u2010cause death using Cox regression, adjusting for potential confounders.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Of 2100 patients, 44.0% were newly prescribed rate\u2010control medications, 4.6% were prescribed antiarrhythmic medications, 8.9% were prescribed both, and 42.9% were prescribed neither within 12\u2009months of newly diagnosed AF. During a median 1.66 (interquartile range, 0.45\u20133.39) years, we observed 1406 composite events (stroke and death). Time\u2010updated use of antiarrhythmics alone (adjusted hazard ratio [HR], 0.74 [95% CI, 0.57\u20130.96]) or with rate\u2010control (adjusted HR, 0.72 [95% CI, 0.58\u20130.90]) was associated with lower stroke or death risk versus neither medication. Use of rate\u2010control medications alone was not significantly associated with the composite outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients on dialysis with incident AF, use of antiarrhythmic medications may be associated with lower risk of stroke and death. Future randomized trials are needed to determine the efficacy and safety of antiarrhythmic medications in this high\u2010risk population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.038511","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T06:19:01Z","timestamp":1750054741000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Rate\u2010Control and Antiarrhythmic Medication Use and Risk of Ischemic Stroke and Death in Patients on Dialysis With Atrial Fibrillation"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0484-4385","authenticated-orcid":false,"given":"Benjamin","family":"Lidgard","sequence":"first","affiliation":[{"name":"University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6321-4522","authenticated-orcid":false,"given":"Dongjie X.","family":"Fan","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California","place":["Oakland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8461-5111","authenticated-orcid":false,"given":"Leila R.","family":"Zelnick","sequence":"additional","affiliation":[{"name":"University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3161-5732","authenticated-orcid":false,"given":"Jaejin","family":"An","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Southern California","place":["Pasadena, USA"]},{"name":"Kaiser Permanente Bernard J. Tyson School of Medicine","place":["Pasadena, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7827-7654","authenticated-orcid":false,"given":"Teresa N.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Southern California","place":["Pasadena, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Sum","family":"Lee","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Los Angeles Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6145-4848","authenticated-orcid":false,"given":"Daniel","family":"Singer","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace H.","family":"Tabada","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California","place":["Oakland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9109-0811","authenticated-orcid":false,"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California","place":["Oakland, USA"]},{"name":"University of California, San Francisco","place":["San Francisco, USA"]},{"name":"Stanford University","place":["Palo Alto, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-8628","authenticated-orcid":false,"given":"Nisha","family":"Bansal","sequence":"additional","affiliation":[{"name":"University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-4-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.07.044"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000003933"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/15.6.765"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228405"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9149(03)00904-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2010050459"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2012.03513.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joad.2015.10.002"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00045391-199704000-00004"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.2174\/0929867323666160309114246"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2018.1463042"},{"key":"e_1_3_2_14_2","first-page":"161","article-title":"Rate versus rhythm control in atrial fibrillation","volume":"59","author":"Frankel G","year":"2013","unstructured":"Frankel G, Kamrul R, Kosar L, Jensen B. 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