Abstract

Atrial fibrillation (AF) is a common supraventricular arrhythmia characterized by uncoordinated atrial activation with consequent loss of atrial mechanical function. Patients with Atrial fibrillation have greater than five-fold increase in the risk of stroke compared to the control populations without atrial fibrillation. Purpose : Purpose of current study is to study etiology of AF, modes of presentation of AF, complications of AF, to find relation between various clinical and echocardiographic parameters and stroke, and thereby to identify cases with high risk of stroke. Material and Methods : This study included Eighty consecutive patients of atrial fibrillation, diagnosed, based on clinical grounds, and confirmed by ECG and common etiological factors were included and were subjected to various relevant investigations. The data of the present study after its proper validation calculated and statistically analyzed. Results: The mean age of male cases was 44.50 (±14.46) years and female cases was 35.94 (+14.63) and this was significantly lower than their male counterpart (p<0.05). More than three forth of the total cases i.e. 77.5% were observed with valvular AF, palpitation (83.8%) and dyspnoea (83.8%) were found to be the most common symptoms. Rheumatic heart disease was the most common etiology observed in 77.5% of the cases and Ischemic heart disease constituted second common etiology (12.5%). It was observed that left atrial diameter 51.2 ( +/- 10.97) mms and mean right ventricular diameter 19.24 (+/- 5.89) mms were significantly higher, respectively in valvular atrial fibrillation in comparison with non valvular atrial fibrillation (p < 0.05). Among the cases of rheumatic heart disease, combination of Mitral stenosis with mitral regurgitation was the most common lesion observed in (38.7%). The mean age of cases with stroke was considerably higher compared with cases without stroke (p < 0.05). Other parameters like left atrial diameter and presence of left atrial thrombus were present significantly in cases with stroke (P < 0.05). The usage of OAC/ NOAC was very low and only 16.3% of the cases were on oral anti coagulations. Conclusion : The most common etiology among the cases was rheumatic heart disease 77.5%, followed by ischemic heart disease 12.5% and the most common mode of presentation was palpitation (83.8%) and dyspnoea 83.8%. Presence of isolated mitral stenosis was significantly higher among case with stroke. Increasing age, significant congestive cardiac failure, left atrial diameter and presence of left atrial thrombus were significantly associated with stroke

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