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Main Article Content
Atrial fibrillation: An analysis of etiology and management pattern in a tertiary hospital in Port-harcourt, southern Nigeria
Abstract
Objective: Atrial fibrillation is the commonest chronic arrhythmia and the etiology is widely varied. The aim of this study was to determine the etiology, clinical characteristics and treatment offered to adult patients with atrial fibrillation managed in a referral hospital in Port Harcourt, southern Nigeria.
Methods: Aretrospective study of all the patients referred to the cardiology unit or seen in the cardiac clinic with ECG evidence of atrial fibrillation over one year period July 2012 to June 2013 was carried out. Those with confirmed atrial fibrillation and had transthoracic echocardiographic evaluation were analyzed for the study. Clinical and demographic characteristics and treatment offered to the patients were obtained from their hospital notes. Stroke risk was retrospectively assessed using the CHADS2 score.
Results: Sixty-eight patients comprising twenty nine females and thirty nine males [ratio of 1;1.3] had complete data . Age range was 30-87 years and mean age was 59.81±14.22 years. Mean blood pressures were 126.03± 26.89 mmHg systolic and 67.22± 18.60 mmHg diastolic. Hypertensive heart disease was the diagnosis in forty patients [58.82%], dilated cardiomyopathy in thirteen [19.2%], rheumatic heart disease in ten [14.71%], thyrotoxicosis in three [4.41%], one each due to endomyocardial fibrosis [EMF] and Cor pulmonale. Ten patients (14.71%) had valvular atrial fibrillation (AF) while most [ 85.29%] had non-valvular AF. None of the patients had evidence of stroke risk evaluation in their notes and less than 10% received anticoagulation treatment despite all the patients having moderate to high risk of stroke from our own CHADS2 evaluation.
Conclusion: Hypertensive heart disease was the commonest cause of atrial fibrillation in patients seen Port Harcourt, Southern Nigeria, followed by dilated cardiomyopathy and rheumatic heart disease. Stroke risk evaluation was non-existent and adherence to guidelines in management of atrial fibrillation was suboptimal.
Keywords: Atrial fibrillation, thrombosis, CHADS2 Score, stroke risk, hypertensive heart disease, cadiomyopathy
