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[Patients admitted with atrial fibrillation to a regional hospital]
János Tomcsányi1, Miklós Somlói
1Budai Irgalmasrendi Kórház, Kardiológia, Budapest.
Insights
Atrial fibrillation affects 13% of hospital admissions in older adults, often presenting as heart failure or ischemic symptoms. Treatment trends show increased use of beta-blockers and newer antiarrhythmics.
Area of Science:
- Cardiology
- Geriatrics
- Internal Medicine
Context:
- Atrial fibrillation incidence rises with age, particularly over 65.
- Limited data exists on atrial fibrillation admissions in regional hospitals.
- This study addresses the gap in understanding atrial fibrillation's role in hospital admissions.
Purpose:
- To determine the incidence of atrial fibrillation in regional hospital admissions.
- To identify common presenting features and associated cardiac conditions.
- To analyze the types of atrial fibrillation and treatment patterns.
Summary:
- The study found atrial fibrillation in 13% of admissions (mean age 71).
- Dyspnea, palpitations, and heart failure were common presentations.
- Hypertension was the most frequent comorbidity (64%).
- Treatment involved beta-blockers, propafenone, sotalol, and amiodarone.
Impact:
- Atrial fibrillation remains a significant cause of hospital admission.
- Clinical features often mimic heart failure or ischemic heart disease.
- Treatment has shifted towards beta-blockers and newer antiarrhythmics, with decreased use of digoxin and Class IA agents.
Introduction:
It is well known that the incidence of atrial fibrillation increased with age over 65 years. However the role and incidence of atrial fibrillation in the admission in the regional hospital was not investigated. The aim of the study was to investigate the incidence, the commonest presenting features, associated cardiac conditions and the different types of atrial fibrillation which were admitted to our regional hospital during the last 10 month.
Results:
The incidence of atrial fibrillation was 13% (mean age: 71 years). The presenting features were dyspnea (28%), palpitation (25%), heart failure (19%), angina (10%), syncope/vertigo (5%), symptoms-free (13%). The most frequently associated cardiac condition was hypertension (64%). The patients were treated with the following antiarrhythmic drugs: beta-adrenergic blocker: 25%, propafenon (15%), propafenon and beta-adrenergic blocker (25%), sotalol (17%), amiodarone (13%), others (5%).
Conclusion:
Nowadays atrial fibrillation is still a remarkable percentage of hospital admission. The most frequent clinical features were not the signs of arrhythmia but the signs of heart failure and ischaemic heart disease. In the treatment of atrial fibrillation the use of digoxin and class IA type antiarrhythmic agents were remarkably decreased and the use of class III, IC and beta-adrenergic blockers increased.