Variance in Clinical Profile and Use of Anticoagulants in Valvular and Non Valvular Atrial Fibrillation

Introduction: Atrial fibrillation is the most common cardiac arrhythmia encountered in clinical practice that affects morbidity and mortality to a large extent. This study was intended to determine various clinical profile and etiological factors in valvular and non-valvular atrial fibrillation and evaluate the usage of anticoagulants in them in the settings of developing nation like ours. Methods: A hospital based cross-sectional observational prospective study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Nepal for a period of sixteen months. All the patients with atrial fibrillation who were admitted in the cardiology department were included. The demographic profile, etiology, clinical features and the usage of anticoagulants were recorded. Results: A total of 175 patients with atrial fibrillation were enrolled in the study with 62% nonvalvular and 38% valvular cases. The overall mean age was 60 ± 16.79 years but among valvular atrial fibrillation, it was 47.9 ± 14.013 and among nonvalvular atrial fibrillation, it was 67.85 ± 13.507 years. Majority of patients were female (56%). Sixty percent were from outside Kathmandu valley. Rheumatic heart disease was the most common cause (38.9%) followed by dilated cardiomyopathy, systemic hypertension, degenerative valvular heart disease, coronary artery disease, etc. The most common presentation was dyspnea. About 79% of valvular and 17% of nonvalvular atrial fibrillation patients were using anticoagulants. Conclusion: Atrial fibrillation was common in young females and rheumatic heart disease was the leading cause. There was inadequate use of anticoagulants in both valvular and nonvalvular atrial fibrillation probably due to the economic constraints and geographical hurdles.