CLINICO-ETIOLOGICAL PROFILE OF ATRIAL FIBRILLATION IN A TERTIARY CARE HOSPITAL

Background And Objectives: Atrial Fibrillation is one of the frequently encountered arrhythmia in our population. This also has a significant effect on economic burden to the society by causing both morbidity and mortality. This study is intended to find out the varied presenting symptoms of AF and also possible underlying predisposing factors- cardiac and non-cardiac in Indian context. Methods: This is a cross-sectional study done over 1 year. All patients above the age of 18 with clinically proven new onset AF and hemodynamically stable were enrolled after obtaining their informed consent. Any arrhythmia other than AF or with hemodynamic instability was excluded. All the demographic characteristics, past history, presence of co morbid illness were noted. Basic blood panel with thyroid profile were obtained. Trans thoracic echo with M-mode and colour doppler was done for every patient. The collected data were analysed with IBM.SPSS statistics software 21.0 Version. For descriptive data, frequency and percentage analysis were used. Results: In our study 63% of patients were females. Most common age group was 41-60 years. Rheumatic heart disease was the most common cause of AF in our study, Systemic hypertension was the second most common cause for AF.CAD was seen in 17 cases, diabetes in 22 cases and COPD in 13 cases Breathlessness was the most common complaint followed by palpitation. Cardiac failure was seen in 37 % of cases while ejection fraction was decreased in 29 patients. Uncontrolled heart rate or tachycardia was seen in 49 % of patients. Coming to ECHO findings, increased LVIDd was seen in 30 patients. Regional wall motion abnormality was seen in 15 % of patients in our study group. Increased left atrial size – the most common ECHO finding seen in atrial fibrillation was present in 61 patients while increased right atrial size was seen in 26 patients. Conclusion: Rheumatic heart disease was the most common aetiology followed by dilated cardiomyopathy in our patients. Breathlessness was the most common presentation, complete echocardiographic evaluation is valid in these patients for etiological evaluation and follow up.