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ORIGINAL ARTICLE
Year : 2019  |  Volume : 5  |  Issue : 2  |  Page : 150-154

Clinical evaluation and management strategy of hospitalized patients with atrial fibrillation at tertiary care centre -IGIMS, Patna, Bihar


1 Associate Professor, Dept. of Cardiology, IGIMS, Patna, Bihar, India
2 Senior Resident, Dept. of Cardiology, IGIMS, Patna, Bihar, India
3 Professor & Head, Dept. of Cardiology, IGIMS, Patna, Bihar, India

Correspondence Address:
Ravi Vishnu Prasad
Associate Professor, Dept. of Cardiology, IGIMS, Patna
India
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Source of Support: None, Conflict of Interest: None


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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia diagnosed in the general population. The study was conducted at tertiary care centre-IGIMS, Patna to study clinical profile of hospitalized AF patients and various management strategies employed in these patients. A total of 132 patients with AF were enrolled in the study. The most patients fall below 50- year of age group. Elderly (>60 years) age group comprise 24% of AF patients. There was marginal female predominance - female (53.8%) and male patients (46.2%) with ratio of 1.2: 1. Rheumatic heart disease (RHD) was the most common etiology of AF (59.8%), followed by coronary artery disease(CAD) (11.3%), hypertension (7.5%) and cardiomyopathy (6%). Rheumatic etiology commonly presented below 50 years but CAD and hypertension presented after 50 years. Palpitation was the most common presentation (88%), followed by dyspnea (56%), chest pain (40%), pedal edema (32%) and hypotension (28%). The rate control strategy was adapted in 76 % cases. Stroke prevention strategy was oral anticoagulation (warfarin or acitrom) in 63.6% cases and antiplatelets in 30.3% patients. The beta blockers (59%) were the most common pharmacological treatment followed by amiodarone (39.9%), calcium channel blockers and digoxin (31.8% each). Novel oral anticoagulants (NOAC) were used in 10 patients of non- valvular origin. Heart failure (49.2%) was most common complication noted in AF patients followed by angina (25%), hemoptysis (18.2%) and stroke (7.5%). Among valvular involvement, most patients have mitral valve involvement. Out of 79 cases, 88% have mitral valve involvement ranging from mild to severe variety in isolation and combinations with other valves. Commonest cause was mixed lesion (mitral stenosis with mitral regurgitation). AF with valvular heart disease has shown maximum LA enlargement, normal LV Ejection fraction and predominance LA clot as compared to non valvular AF.


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