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However, more than a few patients remain asymptomatic. Standard resting 12-lead ECG is important for the detection of organic heart diseases, arrhythmias, and electrolyte abnormalities. The ECG should be performed at the introduction of dialysis and periodically thereafter. Exercise ECG should be used to induce and diagnose arrhythmias, while Holter ECG should be used to evaluate the risk of arrhythmias and the effectiveness http://www.selleckchem.com/products/poziotinib-hm781-36b.html of treatment. In dialysis patients with arrhythmias, organic heart diseases should be detected by echocardiography and, stress nuclear imaging tests. If the results of these examinations strongly suggest coronary artery disease, it is necessary to perform coronary angiography (7). ��-blockers are recommended as the mainstay for drug therapy, because they are safe and effective in suppressing any ventricular extrasystoles and other arrhythmias and in preventing SCD (8). In dialysis patients with left ventricular systolic dysfunction (left ventricular ejection fraction http://www.selleckchem.com/products/bay80-6946.html also sudden cardiac deaths (9). According to a report that evaluated the drugs used before cardiac arrest and the outcome after cardiac arrest, ��-blockers and RAS inhibitors dose-dependently improved the outcome (10) Group I antiarrhythmic drugs should be used carefully, because they are likely to increase the mortality rate associated with fatal arrhythmias (11,12). Catheter cauterization as a treatment for ventricular tachycardia is useful in non-dialysis patients (13) and is also considered useful in dialysis patients, but there is no evidence to support this conclusion. The automated external defibrillator (AED) is a device that can save http://en.wikipedia.org/wiki/MYO10 patients if it is applied immediately after the onset of ventricular fibrillation. However, evidence of the benefit of equipping dialysis facilities with AEDs is insufficient (14). The implantable cardioverter-defibrillator (ICD) is reported to improve the outcome of fatal ventricular arrhythmias in dialysis patients (2). However, the risk of death after treatment in patients with stage 4�C5 CKD including dialysis patients is about 40 times higher than in patients with normal renal function (15), and this must be explained to the patients themselves and their families when attempting treatment with the ICD.