Clinical Electrocardiographic and Echocardiographic Features of Atrial Fibrillation in Nigerians: An Analysis of 39 Patients Seen at the Lagos University Teaching Hospital

Purpose: To evaluate the clinical, electrocardiographic (ECG) and echocardiograhic features of adult Nigerians presenting with atrial Fibrillation (AF) at the cardiology unit. Method: All consenting patients presenting to the cardiology unit of LUTH from September 2000 to September 2001 with ECG evidence of AF were recruited into the study. Demographic and anthropometric data were obtained. The subjects had a full clinical examination. 2D and M-mode echocardiogram was performed on the subjects. Result. Of the 39 subjects analysed there were 22 females and 17 males with a mean age of 54.49±14.60. The underlying heart disease distribution was as follows: hypertensive heart disease 46.2%; dilated cardiomyopathy 20.8%; rheumatic heart disease 17.9%; thyrotoxic heart disease 7.7%; hypertrophic cardiomyopathy 5.1%, lone 2.6%. About 23% were asymptomatic for the arrhythmia at diagnosis. Congestive cardiac failure was present in 74% of the subjects with a mean NYHA class of about III. Embolic phenomenon was observed in 15% of the subjects; 12.8% cerebral events and 2.6% limb embolism. Abnormal QRS axis was noted in 33.3%. Ectopic ventricular beats were as follows: uniform ectopics 30.8%; multiform ectopics 10.3% and unsustained ventricular tachycardia 7.7%. Abnormal echocardiographic features are as follows: dilated left atrium 33( 84.62%); abnormal thickness of the interventricular septum and posterior wall 12(30.77%) and 19(48.71%) respectively;Increased left ventricular internal diameter in diastole 20(51.3%) and in systole 25(64.10%); reduced fractional shortening 30(76.9%); spontaneous echoes 7(18.0%) and intramural thrombus 2(5.1%) Conclusion: Commonest underlying heart disease for AF in this study was hypertensive heart disease. Congestive cardiac failure was a frequently documented clinical feature and cerebral embolism remains a very common complication. Nig. Qt. J. Hosp. Med. Vol.12(1-4) 2002: 29-3