Delta of Egypt Atrial Fibrillation Registry Phase Two
Ehab Abdelwahab Hamdy
Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Timoor Mostafa Abdallah
Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Amany Mohamed Allaithy
Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mahmoud Elsaeed Hamada
Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Atrial Fibrillation (AF) is the most frequent cardiac arrhythmia found in clinical practice. The assessed frequency of AF in adults is between 2% and 4%, with greater incidence and frequency rates in developed nations [1,2]. AF prevalence increases with advancing age, and with some cardiac and non-cardiac disorders, also it may exist in the absence of any conditions [2]. We aimed to determine case characteristics, practice patterns, management strategies and outcomes of atrial fibrillation in the delta area of Egypt.
Methods: This registry-based cross-sectional study included 1000 atrial fibrillation patients (with any AF patterns) who were allowed to enter ER in cardiac centers and hospitals in middle Delta of Egypt from April 2020 to March 2021.
Results: 267 patients (26.7%) were unstable. Heart failure, hypertension, and coronary disease were still prevalent comorbidities in our AF dataset, where hypertension accounts for over 50% of all AF cases. Rheumatic valvular heart disorder was a major underlying disease for the development of AF, still about 25.5% by echocardiography. Lone AF still high 20.6%. CHA2DS2VASc score ≥2 is 83.5%. A high proportion of cases were treated with pharmaceuticals for rate control nearly 52.7% of the cases and nearly 30.3% of the cases were given pharmacological medications for the cardioversion to the sinus rhythm and a small proportion of the cases were given electrical cardioversion nearly 7%.
Conclusions: Coronary disease, hypertension, and heart failure were still usual comorbidities in AF. Rheumatic valvular heart disease is still about 25.5% of the total registry. Amiodarone is the most prevalent antiarrhythmic medications (AAD) used. lone AF still high 20.6%. minimal use of novel oral anticoagulant (OAC).
Keywords: AF, hypertension, registry, coronary disease, cardiac arrhythmia, heart failure
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References
Colilla S, Crow A, Petkun W, Singer DE, Simon T, Liu X. Estimates of current and future incidence and prevalence of atrial fibrillation in the US adult population. The American journal of cardiology. 2013; 112:1142-7.
Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. Worldwide epidemiology of atrial fibrillation: A Global Burden of Disease 2010 Study. Circulation. 2014;129:837-47.
Vizzardi E, Sciatti E, Bonadei I, D’Aloia A, Curnis A, Metra M. Obstructive sleep apnoea–hypopnoea and arrhythmias: new updates. Journal of cardiovascular medicine. 2017;18:490-500.
Marijon E, Le Heuzey J-Y, Connolly S, Yang S, Pogue J, Brueckmann M, et al. Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study. Circulation. 2013;128: 2192-201.
Andersson T, Magnuson A, Bryngelsson I-L, Frøbert O, Henriksson KM, Edvardsson N, et al. All-cause mortality in 272 186 patients hospitalized with incident atrial fibrillation 1995–2008: A Swedish nationwide long-term case–control study. European heart journal. 2013;34:1061-7.
Lip GY, Laroche C, Ioachim PM, Rasmussen LH, Vitali-Serdoz L, Petrescu L, et al. Prognosis and treatment of atrial fibrillation patients by European cardiologists: One year follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot registry). European heart journal. 2014;35:3365-76.
Darwish AR, El-seady MA, Allaithy AM, Hamdy EA-E. Delta of Egypt atrial fibrillation registry (DEAF registry): Tanta; 2019.
Gorin L, Fauchier L, Nonin E, Charbonnier B, Babuty D, Lip GYH. Prognosis and guideline-adherent antithrombotic treatment in patients with atrial fibrillation and atrial flutter: Implications of undertreatment and overtreatment in real-life clinical practice; the Loire Valley Atrial Fibrillation Project. Chest. 2011;140:911-7.
Nielsen PB, Larsen TB, Skjøth F, Overvad TF, Lip GY. Stroke and thromboembolic event rates in atrial fibrillation according to different guideline treatment thresholds: A nationwide cohort study. Sci Rep. 2016; 6:27410.
Kirchhof P, Ammentorp B, Darius H, De Caterina R, Le Heuzey JY, Schilling RJ, et al. Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events--European Registry in Atrial Fibrillation (PREFER in AF). Europace. 2014;16: 6-14.
Zubaid M, Rashed WA, Alsheikh-Ali AA, Almahmeed W, Shehab A, Sulaiman K, et al. Gulf Survey of Atrial Fibrillation Events (Gulf SAFE): design and baseline characteristics of patients with atrial fibrillation in the Arab Middle East. Circ Cardiovasc Qual Outcomes. 2011;4: 477-82.
Nabauer M, Gerth A, Limbourg T, Schneider S, Oeff M, Kirchhof P, et al. The registry of the german competence network on atrial fibrillation: Patient characteristics and initial management. Europace. 2009; 11:423-34.
Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S. Epidemiology of atrial fibrillation: European perspective. Clin Epidemiol. 2014;6:213-20.
Singh BN, Connolly SJ, Crijns HJ, Roy D, Kowey PR, Capucci A, et al. Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutter. N Engl J Med. 2007; 357:987-99.
Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137: 263-72.
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021; 42:373-498.