A clinical, electrocardiography and echocardiography study of atrial fibrillation in a tertiary care teaching hospital

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Background and Objective: Atrial fibrillation (AF) is the most common sustained arrhythmia. It is marked by disorganized, rapid and irregular atrial contraction. The aim of our study is to determine various clinical presentations in patients with AF and to assess the underlying heart disease in patients with AF using electrocardiography (ECG) and echocardiography. Subjects and Methods: This study was undertaken at the Vijayanagara Institute of Medical Sciences, Bellary. It was a prospective, observational study conducted from December 2010 to June 2012. Detailed history was taken from the patients and they were examined according to the prepared proforma. Results: The age of the patients varied from 30 to 85 years. In the present study, the male to female ratio was almost equal, with 24 (48%) male and 26 (52%) female cases. Dyspnea was the most common symptom, followed by palpitations. The pulse deficit varied from 10 to 26 per minute. Rheumatic valvular heart disease was the most common etiology of AF observed in the present study. Mitral stenosis was the most common valvular lesion observed in patients with rheumatic heart disease. Congestive cardiac failure was the most common complication observed, followed by embolic phenomenon. Left ventricular enlargement was seen in 18 cases on chest X-ray. Left atrial enlargement was seen in 33 cases, where 24 cases were of chronic valvular rheumatic heart disease on 2D echocardiography. Conclusion: AF was the most commonly seen rheumatic heart disease, followed by ischemic heart disease. Dyspnea was the most common presenting complaint and congestive cardiac failure was the most common complication.

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