Clinical characteristics and outcomes of atrial fibrillation and flutter at the Aga Khan University Hospital, Nairobi
View/ Open
Date
2013-03Author
Shavadia, J
Yonga, G
Mwanzi, S
Jinah, A
Moriasi, A
Otieno, H
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
INTRODUCTION:
Scant data exist on the epidemiology and clinical characteristics of atrial fibrillation in Kenya. Traditionally, atrial fibrillation (AF) in sub-Saharan Africa is as a result of rheumatic valve disease. However, with the economic transition in sub-Saharan Africa, risk factors and associated complications of this arrhythmia are likely to change.
METHODS:
A retrospective observational survey was carried out between January 2008 and December 2010. Patients with a discharge diagnosis of either atrial fibrillation or flutter were included for analysis. The data-collection tool included clinical presentation, risk factors and management strategy. Follow-up data were obtained from the patients' medical records six months after the index presentation.
RESULTS:
One hundred and sixty-two patients were recruited (mean age 67 ± 17 years, males 56%). The distribution was paroxysmal (40%), persistent (20%) and permanent AF (40%). Associated co-morbidities included hypertension (68%), heart failure (38%) diabetes mellitus (33%) and valvular abnormalities (12%). One-third presented with palpitations, dizziness or syncope and 15% with a thromboembolic complication as the index AF presentation. Rate-control strategies were administered to 78% of the patients, with beta-blockers and digoxin more commonly prescribed. Seventy-seven per cent had a CHA(2)DS(2)VASC score ≥ 2, but one-quarter did not receive any form of oral anticoagulation. At the six-month follow up, 6% had died and 12% had been re-admitted at least once. Of the high-stroke risk patients on anticoagulation, just over one-half were adequately anticoagulated.
CONCLUSION:
Hypertension and diabetes mellitus, not rheumatic valve disease were the more common co-morbidities. Stroke risk stratification and prevention needs to be emphasised and appropriately managed.
URI
http://www.ncbi.nlm.nih.gov/pubmed/23612946http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/31660
Citation
Cardiovasc J Afr. 2013 Mar;24(2):6-9. doi: 10.5830/CVJA-2012-064.Publisher
University of Nairobi, Department of cardiology
Collections
- Faculty of Health Sciences (FHS) [10378]