Detection and treatment of high-output cardiac failure resulting from a large hemodialysis fistula.

Hemodialysis fistulas are a cause of high-output congestive heart failure (CHF). A case is reviewed of a patient in whom surgical correction of an excessively high fistula flow led to resolution of CHF. Bradycardia induced by fistula occlusion (Nicaladoni-Branham sign) was not present, but transient occlusion did produce a marked decrease in cardiac output.