Prospective Evaluation of Hospitalized Patients with Atrial Fibrillation in Senegal

Introduction: The purpose of this study was to determine the prevalence, complications and therapeutic strategy in the management of atrial fibrillation.Patients and methods: This was a prospective, descriptive study conducted at the Cardiology Department of the Aristide Le Dantec University Hospital in Dakar, Senegal which included all patients with atrial fibrillation, admitted between September 2006 and June 2007. We studied the clinical, para-clinical variables as well as the therapeutic strategy adopted. For the comparison of parameters we used the student t-test with significant values considered when p<0.05.Results: One hundred patients with atrial fibrillation were admitted during the study period giving a prevalence of 14.2% among admitted cases. The average age of our study cohort was 47.7±18.4years. In our study population, there was heart failure in58%, stroke in 15%, left atrial thrombus in 2% and acute is chemia of the leftleg in one patient. Transthoracic echocardiography showed dilated left atrium in 61% of patients, left ventricular systolic dysfunction in 25 of patients and two cases of left intra-atrial thrombus. Valvular heart diseases was found in 53% of cases. Anticoagulation therapy with low molecular weight heparin and with vitamin Kantagonist was given in 80% and 95% of patients respectively. Pharmacological cardioversion and direct current (DC) cardioversion were performed in 11% and 22% of patients respectively.Conclusion: Atrial fibrillation was more prevalent in young adults with rheumatic valvular heart disease, with rate control the most commonly used therapeutic strategy. The findings justify the need for primary prevention.