ABSTRACT
Background: Atrial fibrillation (AF) is the most prevalent chronic arrhythmia in the heart. AF accounts for one-third of rhythm disorder hospitalizations. AF increases profoundly the risk of stroke, heart failure, and death. This study used P-wave and transthoracic echocardiography with tissue Doppler imaging (TDI) to determine paroxysmal AF predictors in hypertensive individuals. Methods: This case control study was performed on 100 hypertensive adult patients. They were classified into two equal group: Group I included hypertensive patients diagnosed to have paroxysmal AF. Group II (control group) included hypertensive patients with normal sinus rhythm. All subjects were subjected to electrocardiographic and conventional and tissue Doppler Imaging measurements. Results: Pmax had significantly increased in PAF patients compared to sinus rhythm patients. PAL, PAR, PAI, LR, LI and IR had significantly increased in PAF patients compared to sinus rhythm patients. In Multivariate logistic regression analysis, Pmax, PAL, PAI, PAR, LR, LI and IR were found to be independent predictors for PAF. Therefore, Pmax, PAL PAI, PAR, LR, LI and IR were found to be significant predictors for PAF. Best cut-off values for Pmax, PAL, PAI, PAR, LR, LI and IR were: (118, 81, 61, 49.9, 34, 20 and 16 ms) with sensitivity (76, 96, 96, 88, 82, 86 and 77.5 ), specificity (84, 100, 98, 92, 78, 82 and 76) and the AUC of (0.850, 0.979, 0.987, 0.961, 0.836, 0.891 and 0.798) respectively. Conclusions: Electrocardiographic P-wave analysis and echocardiographic TDI may identify hypertension patients at risk for paroxysmal AF, since the combination of Pmax and TDI may help in predicting the development of AF in hypertensive individuals.
ABSTRACT
Background: Atrial fibrillation (AF) is the most common sustained disorder of cardiac rhythm. To study the epidemiology, demography and clinicoetiological profile of nonvalvular atrial fibrillation, such studies are sparse in India.Methods: One hundred sixty-five patients of nonvalvular atrial fibrillation were enrolled prospectively in the study during the period February 2017 to May 2018. Patients with an electrocardiographic documentation of atrial fibrillation, either chronic or paroxysmal were enrolled in the study. Patients underwent thorough physical examination, routine laboratory testing, and other relevant investigations to assess the underlying etiology. Baseline characteristics of all the patients’ viz. type of AF, primary etiological diagnosis, and baseline clinical parameters were noted. Statistical analysis was done using percentage analysis.Results: A total of 165 patients were enrolled in the study. The vast majority of patients were elderly; with the majority being in the 56-65years age group (45.45%). AF was more common in men (56.3%). Systemic hypertension was the most common etiological association (80%).Conclusions: Present study found that advanced age and male gender are significant risk factors for AF. Systemic hypertension is the most common etiological association with nonvalvular AF.