Dr. Murtadha Kudhur Hammod
Context: Atrial fibrillation is the most common sustained arrhythmia, increases with age, and presents with highly variable symptoms and severity. Paroxysmal, persistent, and permanent form require very individualized approaches to management. The most important aspect of diagnosis is the causes, the risk groups and risk stratification with respect to risk of thromboembolism. The general goals in treatment are in order of importance: Prevention of thromboembolism, control of ventricular response, restoration of sinus rhythm, and maintenance of sinus rhythm by preventing recurrence.
Objective: To assess the prevalence of AF with age and sex, causes of AF and risk factors for thromboembolism in AF patients.
Design: prospective study of 150 patients with sustained AF
Setting: Medical ward of Tikrit hospital from
Patient and method: 150 patients were included in this study all have permanent AF. The final diagnosis was based on careful evaluation of clinical data and the results of various investigations, all were studied by history, examination, ECG, radiology, echocardiography and biochemical tests when indicated, ischemic heart disease was diagnosed by the history of chest pain typical of chest pain of myocardial ischemia and electrocardiographic criteria of myocardial ischemia. Prevalence of age and sex with AF, causes of AF, risk factors for thromboembolism were assessed.
Results: AF prevalence increase with age, with peak age between 61-70 year, it was higher in men than women, with men: women ratio 1.3: 1.
IHD is the main cause of AF 74 cases (49.3%), followed by mitral valve disease 37 cases (24.7%), while HPT is the third main cause 15 cases (10%), followed by lone AF 11 cases (7.3%) then the other causes, aortic valve disease 3 cases (2%), thyrotoxicosis 3 cases (2%), cardiomyopathy 3 cases (2%), COPD 2 cases (1.3%), sick sinus syndrome 1 case (0.7%), ASD 1 case (0.7%). Risk factors for thromboembolism in 150 patients with AF were: Age over 65 years 88 case 58.65%. Echocardiography (feature of left atrial enlargement) 83 case. IHD 74 case 49.3%. Heart failure 61 case 40.6%. Mitral valve disease 37 case 24.7%. Previous stroke 33 case 22%. Diabetes mellitus 31 case 20.6%.
Conclusion
1. AF prevalence increase with age, with peak age between 61-70 year.
2. AF was higher in men than women, with men: women ratio 1.3: 1.
3. IHD is the main cause of AF 74 cases (49.3%), followed by mitral valve disease 37 cases (24.7%), while HPT is the third main cause 15 cases (10%), followed by lone AF 11 cases (7.3%) then the other causes, aortic valve disease 3 cases (2%), thyrotoxicosis 3 cases (2%), cardiomyopathy 3 cases (2%), COPD 2 cases (1.3%), sick sinus syndrome 1 case (0.7%), ASD 1 case (0.7%).
4. Risk factors for TE were: Age over 65 years 88 case 58.65%. Echocardiography (feature of left atrial enlargement) 83 case. IHD 74 case 49.3%. Heart failure 61 case 40.6%. Mitral valve disease 37 case 24.7%. Previous stroke 33 case 22%. Diabetes mellitus 31 case 20.6%.
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