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Epidemiologic Aspects of Atrial Fibrillation in a Tertiary Hospital in a Sub-Saharan Africa Setting

DOI: 10.4236/oalib.1103384, PP. 1-8

Subject Areas: Cardiology

Keywords: Epidemiology, Atrial Fibrillation, Cameroon, Sub-Saharan Africa

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Abstract

Background: Atrial fibrillation (AF) is the most frequent sustained arrhythmia. The prevalence is increasing with that of other cardiovascular risk factors in our low-income setting. It is potentially serious due to the associated complications. Few data exist on the epidemiology of AF in Sub-Saharan Africa (SSA). Methodology: We carried out a cross-sectional study between 2005 and 2009 in the Cardiology Unit of the Douala General Hospital. Patients were adults ≥ 18 years of both sex, who had an ECG diagnosis of Atrial Fibrillation and a comprehensive investigation of the cause of AF. Results: A total of 2581 patients were seen in this unit, of whom 182 (7.1%, [95%: 6.1-8.1]) had AF. Their mean age was 59.2 ± 15.4 years, and there were 100 (58.2%, [95% CI: 51-65.6], p = 0.002) females. Hypertension was the most frequent risk factor (77.3%, [95% CI: 70.3-82.8]), and 163 (95.3%, [95% CI: 90.7-97.8]) of the patients were symptomatic. Hypertensive heart disease (45.6%, [95% CI: 38.3-53.1]), idiopathic dilated cardiomyopathy (19.3%, [95% CI: 14.1-25.9]), and valvular heart disease (16.4%, [95% CI: 11.6-22.6]) were the main etiologic factors of AF. The most frequent complications were heart failure seen in 77 (45%, [37.8-52.5]) and ischemic stroke in 27 (15.5%, [95% CI: 11.1 - 22]) of patients. Digoxine was prescribed in 121 (70.8%, [95% CI: 63.6-77.1]) patients to control heart rate, while amiodarone was prescribed in 67 (29.2%, [95% CI: 32.2-46.7]) patients to revert to sinus rhythm. No electrical cardioversion was carried out. Aspirine was prescribed in 119 (69.6%, [95% CI: 62.3-76]) patients, and anti-vitamin K in 53 (30.4%, [95% CI: 24.5-38.3]) patients. Conclusion: Atrial fibrillation was seen in seven percent of patients in the Cardiology Unit of this low-income setting. Patients were relatively young compared with high income settings. Hypertension, idiopathic dilated cardiomyopathy, and valvular heart disease were the main causes. Rate control was the main treatment strategy. Oral anti-coagulants were less frequently used.


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Kamdem, F. , Hamadou, B. , Kamdem, M. , Nganou, C. N. , Dzudie, A. , Monkam, Y. and Kingue, S. (2017). Epidemiologic Aspects of Atrial Fibrillation in a Tertiary Hospital in a Sub-Saharan Africa Setting. Open Access Library Journal, 4, e3384. doi: http://dx.doi.org/10.4236/oalib.1103384.

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