English

Abstract

CONTEXT: Atrial fibrillation is the most common cardiac arrhythmia in clinical practice. In developing countries like India, the high morbidity and mortality associated with this condition, warrants detailed assessment. AIMS: To find the epidemiological and etiological factors associated with atrial fibrillation. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Medical Hospital in Rewa (MP), during 2010 and 2011 on 125 patients. METHODS & MATERIAL: A complete general and systemic examination to be carried out on subjects presenting with Atrial Fibrillation on Electrocardiography followed by Echocardiographic analysis. RESULTS: Out of 125 patients, who presented with Atrial Fibrillation (AF), 56.8% were females and 43.2% were males. While 102(81.6%) patients were above 40 years, 23(18.4%) were below 40 years of age. 84% of cases were reported from rural area whereas 16% were from urban area. Most common aetiology associated with AF was rheumatic heart disease (RHD) (45.6%) followed by coronary artery disease (CAD) (18.4%) and hypertension (12%). Most common etiologic factor found among rural population was RHD (51.4%). Among the urban population 30% had CAD while 15% had RHD aetiology. Above 50 years of age, most common etiologic factor associated was CAD (30%), followed by RHD (24%). Echocardiographic Left Atrium (LA) size was more than 4cm in 79.2% of patients. Maximum LA enlargement was found in RHD patients (57.07±10.8mm). Among valvular lesions, maximum LA size was seen with mitral regurgitation (68.7±9.1mm). Coarse AF was present in 48% of patients studied .Of these majority were associated with RHD (63.3%) and 86.6% of these patients had LA size more than 4 cm. LA thrombus was seen in 4.8% patients. CONCLUSION: Most common aetiology associated with atrial fibrillation in our set up is RHD. In our population the disease is more common in rural area having a female predominance and younger age of onset. Risk of atrial fibrillation increases with age, and it is more frequently associated with CAD than RHD. Patients with Echocardiographic LA size more than 4 cm had an increased risk of atrial fibrillation.