Analyse rétrospective de la prise en charge de la fibrillation atriale dans un service de cardiologie à l’Institut de Cardiologie d’Abidjan (Côte d’Ivoire)

Objective

The aim of this study was to analyze the management of atrial fibrillation in a cardiology department in sub-Saharan Africa.

Methodology and results

We conducted a retrospective study of 146 consecutive patients aged at least 18 years hospitalized for atrial fibrillation over a two-year period in our cardiology department at the cardiology institute of Abidjan (Côte d'Ivoire). The mean age of the study population was 61.2 ±15.5 years, and the majority were women (51.4%). The respective prevalences of paroxysmal, persistent, and permanent fibrillation were 11.6%, 4.1%, and 32.2%.

The underlying pathologies found in 105 patients were: hypertensive heart disease (47.2%), valvular heart disease (15.7%), and dilated cardiomyopathy (4.1%). A heart rate control strategy was chosen in the majority of cases (84.2%). Beta-blockers (36.3%), digoxin (20.5%), and amiodarone (18%) were the most commonly used drug classes. The mean CHA2DS2VASc score was 3±1.57, and 85.2% of patients had a CHA2DS2VASc score ≥ 2. Of the patients requiring oral anticoagulation, 91 (76.5%) received it.

Conclusion

Atrial fibrillation is severe in our context because of the greater prevalence of heart failure, hypertensive heart disease and cardiovascular risk factors, all of which increase the risk of thromboembolism. The heart rate control strategy was predominant and oral anticoagulation was correctly prescribed in 76.5% despite a high CHA2DS2VASc score.