Characterization of atrial fibrillation in the Department of Internal Medicine at “Hospital Nacional San Rafael” (El Salvador)

Abstract

Introduction: Atrial fibrillation is a serious health problem. Central American countries are not exempt from this scourge. Objective: To characterize atrial fibrillation, specify its clinical and epidemiological variables and determine stroke risks by using CHA2DS2-VASc score. Method: A descriptive and prospective study was carried out on 107 patients admitted with diagnosis of atrial fibrillation, in the Department of Internal Medicine at “Hospital Nacional San Rafael” from Santa Tecla city, La Libertad, El Salvador, from January to July 2013. The clinical and epidemiological variables were analyzed, an echocardiogram was performed on all patients and CHA2DS2-VASc risk score was calculated. Methods were used to establish the relationships between variables. Results: More than half of atrial fibrillation patients (57.0%; p=0.015) are women, 51.4% white and the average age is 74.7 ± 13.8 years. 80.4% of patients have non-valvular atrial fibrillation. There was hypertension prevalence (54.2%), ischemic heart disease (28.0%), hypertensive (23.4%) and dilated cardiomyopathies (24.3%), and permanent atrial fibrillation (49.5%). The left atrium average size was 42.67 ± 8.2 mm. The lower ejection fraction (p=0.012) and increased left ventricular diastolic diameter (p=0.004) showed significant relationship with the occurrence of non-valvular atrial fibrillation. 84.9% of patients have a high risk of stroke according to CHA2DS 2-VASc score. Age older than 75 years (p <0.001), between 65 and 74 (p=0.025), female sex (p=0.001) and increased thickness of the interventricular septum (p=0.006) were associated with higher risk. Conclusions: The lower ejection fraction and increased left ventricular diastolic diameter were associated with atrial fibrillation. Most patients have a high risk of stroke; variables associated are older age, female gender and increased thickness of the interventricular septum