A Study of Epidemiology, Clinical Profile, Management of Atrial Fibrillation in Rural Area

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S. R. Ranga Bashyam, Moogaambiga, Abishek Srihari, Rathis T. S.


Background: AF is the most common sustained heart rhythm disorder in the general population with a community prevalence of 0.5-5.5% worldwide. Studies conducted in India have shown wide variations in AF prevalence, ranging from 0.1 to 1.6 %. Unfortunately, in India population-based information on AF is limited. Moreover, the available knowledge on AF and oral anticoagulation (OAC) practices are largely derived from the hospital-based studies. Till date, there are only two community based prevalence studies on AF in India. Hence the study team decided to take up a project to focus the epidemiological aspects of the disease.

A Prospective observational study was conducted on 311 adults (>18 years age), suffering with atrial fibrillation; satisfying inclusion and exclusion criteria at Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem for a period of 18 months (from January 2021 to June 2022).  Ethical and Research Committee clearance was obtained from Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem. After taking informed written consent; history and clinical examination was done and data needed was recorded, entered in a data collection sheet in Excel format and analysed using SPSS Software.

Results and Conclusion: The present study concludes that patients aging 41-50 years were at the higher risk of AF. The mean age was found to be 45.78±10.87 years. Female gender shown preponderance. Patients belonging to lower socioeconomic status were suffering from AF the most. The social habits like smoking, alcoholism were posing risk to develop AF. Chief symptoms of patients include palpitation, shortness of breath, chest pain, fatigue, limb weakness, syncope and others like cough. The disease conditions contributing to the etiology of AF include rheumatic heart disease (RHD), systemic hypertension, coronary heart disease, hyperthyroidism, dilated cardiomyopathy, mitral valve prolapse syndrome, chronic obstructive pulmonary disease, drug induced, lone or undetermined AF. Patients with rheumatic heart disease and AF had a mean age of 41.25±6.57 years. There was a female preponderance. Most subjects were in class III of NYHA classification. There was a significant statistical difference between subjects with RHD and those without RHD in terms of serum creatinine, LVED diameter and LVEF %. The common drug classes were diuretics, ACE inhibitors, ARBs, β-blockers, inotropes, sodium channel blocker, calcium channel blockers.

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