The Echocardiographic Findings in Patients with Atrial Fibrillation in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study

Abstract

Introduction: Atrial fibrillation is the most prevalent supraventricular arrhythmia responsible forthe large morbidity and mortality burden worldwide. There are various causes of atrial fibrillationthat may affect the prognosis of patients. This study was intended to determine different echocardiographic findings in patients with atrial fibrillation in a tertiary care center. Methods: A descriptive cross-sectional study was conducted at Manmohan Cardiothoracic Vascularand Transplant Center, Institute of Medicine, among 175 patients with atrial fibrillation admittedin the cardiology department from June 2017 to October 2018. It was approved by the InstitutionalReview Board of the Institute of Medicine (Ref.:411(6-11-E)2/073/074). Convenience sampling wasused. Statistical analysis was done using Statistical Package for Social Sciences version 21.0. Results: A total of 175 patients with atrial fibrillation were enrolled where Rheumatic heart disease 68 (38.9%) was the leading cause in which 54 (79.4%) had mitral valve lesion, 1 (1.5%) hadaortic valve lesion and rest had a combination of both. The mixed lesion of mitral stenosis and mitral regurgitation was the commonest. The left atrium size was larger in valvular atrial fibrillation(47.29±6.651mm). The left ventricular systolic dysfunction was seen more in non-valvular atrialfibrillation. The commonest site of thrombus formation was left atrium 7 (63.6%). Conclusions: Atrial fibrillation was common in rheumatic heart disease, especially mixed lesions ofmitral stenosis and regurgitation. Valvular atrial fibrillation had a larger left atrium. The thrombuswas seen in mitral stenosis and left ventricular systolic dysfunction. The left atrium size and left ventricular ejection fraction were associated with the occurrence of atrial fibrillation.