Clinical and echocardiographic study of atrial fibrillation

Vemula Narendar, Sanda Mallikarjuna Rao


Background: Atrial fibrillation is associated most commonly with mitral valve disease. Atrial fibrillation is reported to occur in 29% of patients who have isolated mitral stenosis and in 16% who have isolated mitral regurgitation. The incidence increases to 52% in mitral stenosis combined with regurgitant lesions of rheumatic etiology.

Objective is to study the incidence, clinical features, etiology and complications of atrial fibrillation.

Methods : A hospital based cross sectional study was conducted among 60 cases of atrial fibrillation at Mamata General Hospital, Khammam from July 2008 to March 2009. All cases were examined in detail as per the questionnaire with special reference to cardiovascular system. In each case, history of present and past illness was carefully inquired into so as to obtain a complete historical background of the case. Investigations, electrocardiogram and echocardiography were carried out. Data was entered in Microsoft Excel sheet and analyzed using proportions.

Results : There was female predominance. The age ranged from 19 years to 85 years. Atrial fibrillation patients with rheumatic etiology commonly presented below 50 years. The chief complaints were found to be dyspnoea, palpitations, pedal edema, chest pain, hemoptysis and weakness of the limbs. The duration of symptoms ranged from 15 days to 20 years. Rheumatic heart disease was found to be the most common cause in 73.33% of cases. Mitral stenosis was the most common lesion among patients with rheumatic heart disease. The ventricular rate ranged between 60-180/min. Congestive cardiac failure was the commonest complication.

Conclusions : Chronic atrial fibrillation due to rheumatic etiology was more common in younger group. Females were more commonly affected than males. Rheumatic heart disease was the commonest cause followed by ischemic heart disease and hypertension. The common complications were congestive cardiac failure, angina and embolic stroke. Most of the cases of chronic atrial fibrillation were associated with large left atrial size.


Atrial fibrillation, Mitral valve disease, Complications

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