Analytical study of Atrial Fibrillation in Government Stanley Hospital, Chennai

INTRODUCTION: Atrial fibrillation is a condition of increasing clinical and economic importance. It is the most common arrhythmia encountered in clinical practice. AF is a supraventricular tachyarrhythmia characterized by uncoordinated atria activation with consequent deterioration of atrial mechanical function. Atrial fibrillation is associated with substantial mortality and morbidity. It is caused by many cardiac and non cardiac conditions. AF coexists with common cardiovascular conditions, such as hypertension, heart failure,coronary heart disease and diabetes mellitus, and with an increasing older general population af will become an increasing health care burden. AF is increasing in incidence and prevalence. The estimated prevalence of AF in general population is 0.4%. The prevalence and incidence increases with advancing age, affecting approximately 5% of individuals older than 65 years and nearly 10% of those aged older than 80 years. In the Framingham study, yearly incidence rates for persons age 50–59 were approximate 1–9 and 0–9 per 1000 person years in men and women respectively. Over 38 years of follow up, the Framingham study found an over all incidence rate of approximately 3 per 1000 years in men and 2 per 1000 years in women aged 55 – 64 years. The incidence of AF doubled, for every decade increment in age in the Framingham heart study cohort. Men are at moderately higher risk of AF than women, however the onset of AF in women occurs later in life. Prognostically the prevalence of AF is associated with five-fold increase in morbidity risk and a two-fold increase in mortality risk. Most complications and Death associated with AF are due to complications associated cerebrovascular embolic events. Pharmacological treatment modalities form the mainstay of treatment. Recent research has highlighted new approaches to both pharmacological and non pharmacological management strategies.Newer antiarrhythmic agents have been developed and others are being evaluated for their potential use in atrial fibrillation. AIM OF STUDY: To analyse the etiological factor, clinical presentation and complications of 50 cases of Atrial fibrillation in Government Stanley Medical College Hospital, Chennai-1. MATERIAL AND METHODS: This study was conducted at Government Stanley Medical College Hospital, Chennai during the period of January 2007 to June2007. Fifty cases of patients admitted with atrial fibrillation were recorded. No patient had been counted to if he/she got admitted again after discharge. Paediatric age group (13 Yrs and Less) was not included in this study. CONCLUSION: The Commonest etiology causing atrial fibrillation was Rhenmatic heart disease, which contributed to 60% of the cases. • The majority of the cases of Atrial fibrillation were in the 4th or 5th decade. • There were no significant sex differences in the distribution of Atrial fibrillation but in Dilated cardiomyopathy had a predominant female preponderance. • Rheumatic heart disease patients with atrial fibrillation had a mean of 35.7 years, while patients with ischaemic heart disease had a mean of 58.3 years. • In Rheumatic heart disease the predominant lesion causing AF was mitral valve lesion. • The commonest clinical manifestation causing Atrial fibrillation was palpitations followed by dyspnoea. • A Left atrial size of >4 cm predisposes to Atrial fibrillation in Rheumatic Heart Disease. • The major complication of atrial fibrillation was precipitation of cardiac failure. • Atrial fibrillation perse does not cause cardiac failure in a majority of cases. But it may precipitate overt cardiac failure in a haemodynamically compromised heart as in rheumatic heard disease and pump failure as in DCMP and CHD. Since majority of the cases in the study were rheumatic heard disease precipitation of cardiac failure was the major complication