Non-valvular atrial fibrillation: diagnostic and therapeutic aspects about 45 cases in a cardiology department of Sikasso hospital in Mali

Abstract

Describe the diagnostic and therapeutic aspects of non-valvular atrial fibrillation. It was a descriptive cross-sectional study during a period of two years from October 1st, 2014 to September 30th, 2016. Were included in the study patients with atrial fibrillation hospitalized at the cardiology department of Sikasso hospital in Mali. Forty five patients were includes with a hospital rate of 3.33%. The mean age was 45 year (30-89 years) with a sex ratio of 0.66. Symptoms were dominated by those of heart failure (42.2%). Persistent atrial fibrillation were more frequent. Subjacent cardiopathy was dominated by hypertensive heart disease (51, 1%) follow by dilated cardiomyopathy (15,5%). Tachycardia was noticed at admission in 71,6% cases. Echocardiography noted a left atrium dilatation in 33,8% of case, an alteration of left ventricular fraction ejection in 37.8%. The CHA2DS2VASc score of 2 or higher was found in 72,6% of patient and the HAS-BLED score of 3 or higher was found 3 in 13%. The anticoagulation therapy was prescribed in 92,7% of case in whom vitamin K antagonist was used in 87,2%. Digoxin was prescribed in 78%, beta-blockers in 11% and calcium canal blocker in 3%. Nine dot eight percent of case were given a direct cardioversion treatment in 3,12% or electrical treatment in 6.68%. Among the latter, a sinus rhythm was restored in 7, 35% case. Complications were dominated by heard failure (52%) followed by thromboembolic events (17,8%). The mean of the hospital's duration was 9 days and the rate of mortality of 3.6%. Our work has come to point out the occurrence of non-valvular AF in young people, the weight of hypertensive heart disease, the high thrombotic risk level and also the significant usage of digoxin.