Atrial fibrillation among the black population in a Ugandan tertiary hospital

BACKGROUND Atrial fibrillation (AF) is the most common type of sustained cardiac arrhythmia in adults, accounting for one-third of hospitalizations due to arrhythmia and related complications worldwide. Previously, rheumatic heart disease was documented as the commonest cause of AF in sub-Saharan Africa. However, due to the prevailing epidemiological transition in sub-Saharan Africa, the risk factors and ensuing complications of AF have changed and are on the increase. METHODS This was a descriptive cross-sectional study involving 102 patients presenting with AF who were recruited from the cardiology unit of Mulago National Referral Hospital, Uganda, over 3 months. Sociodemographic, medical history, and clinical data were obtained. RESULTS The mean age of study participants was 52±21.3 years with a female predominance (58 [56.9%]). The commonest coexisting medical conditions were hypertension in 42% and rheumatic heart disease in 32% of the patients. The commonest echocardiographic abnormality was chamber dilation, noted in 76.8% of all patients. Heart failure was the most frequent complication encountered (50%) followed by left ventricular diastolic dysfunction and acute thromboembolic stroke documented in 19.6% and 12.8% of the study participants, respectively. Of the enrolled patients, ten (9.8%) died within 3 days of admission. CONCLUSION AF tends to occur at a younger age in Ugandan patients. The commonest underlying medical conditions among these patients were hypertension and rheumatic heart disease. Hence, all patients with hypertension and rheumatic heart disease should be meticulously screened for AF.