Clinical factors associated with Atrial Fibrillation in congestive Heart Failure patients admitted at the University Teaching Hospital, Lusaka, Zambia

Introduction: Atrial fibrillation (AF) and congestive heart failure (CHF) have emerged as major global epidemics. These two conditions share common risk factors and frequently coexist. Each condition predisposes to the other, and the concomitant presence of the two has additive adverse effects. This study examined the clinical factors associated with AF in CHF patients admitted at the University Teaching Hospital (UTH), Lusaka, Zambia.
Methods: A hospital-based cross-sectional study was conducted at UTH adult medical wards. The data and anthropometric measurements were collected from patients who consented for enrolment from June 2014 to August 2014. A structured interview schedule was used to capture the socio-demographic and related historical data; and an Omron HEM 780 automated Blood Pressure machine was used to measure Blood Pressure and pulse. Then all patients had a standard 12-lead ECG done on them using Schiller AT-102 ECG machine to detect the presence or absence of atrial fibrillation. Those participants whose standard 12-lead ECG results did not show the presence of AF, had 24-hours ECG DR180+ Digital Recorder applied to try to pick-up paroxysmal atrial fibrillation. Then finally all participants with any form of AF were assessed for clinical factors such as NYHA class, age, obesity, coronary heart disease, coexistence with non-cardiovascular diseases (e.g. chest diseases, diabetes mellitus), and smoking. Pearson chi-square of independence of the data was carried out using IBM® SPSS® Statistics for Windows version 20.0 to determine clinical factors of atrial fibrillation in congestive heart failure patients.
Results: A total of 49 patients were included in the study and out of these, 13 (26.5%) had atrial fibrillation. The prevalence of atrial fibrillation in congestive heart failure was found to be strongly associated with age 65 years and above, obesity, smoking, excessive alcohol intake, hypertension, dilated cardiomyopathy, diabetes mellitus and chronic lung disease. These findings suggest the need for clinicians taking care of the congestive heart failure patients to consider full scale use of ambulatory ECG monitors in all congestive heart failure patients with the above conditions.
Keywords: ECG DR180+ Digital Recorder, smoking, cardiomyopathy, diabetes, lung disease