The goal of a new study published in the Giornale Italiano di Nefrologia was to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in dialysis centers of Lombardy. Data was collected from 18 centers for 3395 patients undergoing replacement renal therapy, including 2907 (85.6%) in hemodialysis and 488 (14.4%) in peritoneal dialysis. The findings showed that all centers used the 12-lead ECG in case of evocative symptoms of an arrhythmic event, while 2/3 performed examination with programmed cadence (usually once a year). On the other hand, 24-hour ECG Holter was not a routinely used diagnostic tool. Moreover, the proportion of cardiac devices was relatively high, with respect to literature data. Among the patients, 4.9% had pace-makers, 1.5% had intra-cardiac defibrillators, 0.5% had undergone resynchronization therapy, and 0.7% were with resynchronization therapy and intracardiac defibrillators. It was stated that the findings of this survey rendered interesting information and could be an important starting point for the optimization of clinical practice and collaboration between nephrologists and cardiologists to resolve a major complication, such as arrhythmic disease, in patients on renal replacement therapy.