STUDY OF CLINICAL, ETIOLOGICAL AND ECHOCARDIOGRAPHIC PROFILE OF PATIENTS WITH ATRIAL FIBRILLATION IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Abstract

Atrial Fibrillation (AF) is the most common sustained arrhythmia in clinical practice. In our country, most of the data related to AF has been derived from international studies with an Indian cohort. We studied etiology, left atrial size and the incidence of left atrial appendage clot in patients with atrial brillation at our institution so that guidelines could be formulated to manage the patients of AF in the hours of emergency. The study population consisted of 203 hemodynamically stable patients with AF over a period of 1 year. After getting ethical committee clearance, appropriate clinical examination and investigations including detailed 2D echocardiography were carried out. Mean age of the patients in our study was 42.6 ± 13.4 years. Maximum number of patients was in the age group of 20-39 years (42.4%). Majority were females (65.5%). The most common symptom was shortness of breath (64.5%) followed by palpitation (59.6%). 57.6% cases were due to RHD and 13.8% due to systemic hypertension. Most common Valvular abnormality was found to be combined MS and MR (43.6%) followed by isolated MS (22.2%). The mean LA diameter was 46.3 ± 7.0 mm. Out of 117 RHD patients, 42.7% had severely abnormal LA diameter. LA clot was present in only 4.9% of the patients who all had RHD. 7.4% had some embolic complications. Mean LA diameter was signicantly different between RHD and non-RHD cases (48.97 ± 7.5 mm vs 42.66 ± 4.1 mm). There was a signicant association between severity of MS and LA diameter. No signicant difference was found between different category of MV abnormality and mean LA diameter. There was signicant increase in the rate of heart failure with increase in LA diameter abnormality.