Magnitude and Associated Factors of Atrial Fibrillation, and its Complications among Adult Rheumatic Heart Diseases Patients in Governmental Hospital in Bahir Dar Town, Northwest Ethiopia 2024

Abstract

Abstract Introduction: Atrial fibrillation (AF), is characterized by high-frequency stimulation of the atrium, causes dyssynchronous atrial contraction and irregular ventricular excitation. Hospital-based studies in Africa have reported AF prevalence rates between 0.7% and 55.7%. In Ethiopia, the prevalence of AF among rheumatic heart disease was 46.8%. Studies conducted in Ethiopia, and other studies does not addressed comorbidity related factors associated with atrial fibrillation like ischemic heart disease, hyperthyroidism, and dyslipidemia by adding this variables I was conducted a research in the area of interest. Objective: To assess the magnitude and associated factors of atrial fibrillation, and its complications among adult rheumatic heart diseases patients in governmental hospital in Bahir Dar town, Northwest Ethiopia 2024. Methods: An institutional-based cross-sectional retrospective chart review study design was used, with in the study period from May 10, 2024 to June 9, 2024. With a sample size of 421. A simple random sampling technique was used to select the patient charts. Data was entered, cleaned, and coded and then analyzed using SPSS version 26 software. A bivariable and multivariable logistic regression model was used, and a P-value < 0.05 was considered statistically significant. Result: In this study a total of 402 rheumatic heart disease patients were included. The response rate was 95%. Majority of them were female (56%). Out of 402 patients 51.2% was developed atrial fibrillation. Age >50 years old (AOR= 7.20(2.03-25.46)), left atrium size (AOR=1.23(1.14-1.33)), sever tricuspid regurgitation 4.50(1.18-17.20)), and left ventricular ejection fraction % (AOR=0.94(0.89-0.99)) was associated with AF. The present study showed that complication related to atrial fibrillation was HF (72.8%), ischemic stroke (34.4%), systemic thromboembolism (12.1%). Conclusion and recommendation: More than half of the study participants were found to have atrial fibrillation in patients with RHD. In this study, atrial fibrillation was a fivefold increased risk of ischemic stroke and two fold increased risk of systemic thromboembolism. Advancing screening strategies, such as Holter monitoring, focuses on all RHD patients to detect AF early and reduce its complications, should be recommended. Key word: atrial fibrillation, rheumatic heart disease, stroke, Ethiopia