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Published on: February 26, 2013
Clinical presentation, management, and outcomes in the Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF)
Insights
Indian atrial fibrillation (AF) patients are younger, with rheumatic valvular heart disease being a common cause. One-year follow-up revealed significant mortality and morbidity in this population.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Atrial fibrillation (AF) is a growing public health concern globally.
- Understanding the specific epidemiological profile and outcomes of AF in India is crucial for targeted interventions.
Purpose of the Study:
- To establish a national registry for atrial fibrillation (AF) in India.
- To collect data on AF epidemiology, clinical characteristics, treatment, and 1-year outcomes.
Main Methods:
- The Indian Heart Rhythm Society (IHRS)-AF registry enrolled 1537 patients from 24 sites in India (July 2011-August 2012).
- Baseline characteristics and 1-year follow-up data were collected and analyzed.
Main Results:
- The average age of Indian AF patients was 54.7 years, with a slight female predominance.
- Rheumatic valvular heart disease (RHD) was the most frequent comorbidity (47.6%).
- At 1-year follow-up, 45.6% had permanent AF, with 6.5% annual mortality, 8% hospitalization, and 1% stroke incidence.
Conclusions:
- Indian AF patients are notably younger compared to global averages, with RHD as a primary etiology.
- A significant proportion (two-thirds) present with persistent or permanent AF.
- The 1-year follow-up highlights substantial mortality and morbidity among Indian AF patients, underscoring the need for improved management strategies.
Aim:
A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes.
Methods:
A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed.
Results:
The average age of Indian AF patients was 54.7 years. There was a marginal female preponderance - 51.5% females and 48.5% males. At baseline, 20.4% had paroxysmal AF; 33% had persistent AF; 35.1% had permanent AF and 11% had first AF episode. At one-year follow-up, 45.6% patients had permanent AF. Rheumatic valvular heart disease (RHD) was present in 47.6% of patients. Hypertension, heart failure, coronary artery disease, and diabetes were seen in 31.4%, 18.7%, 16.2%, and 16.1%, respectively. Rate control was the strategy used in 75.2% patients, digoxin and beta-blockers being the most frequently prescribed rate-control drugs. Oral anticoagulation (OAC) drugs were used in 70% of patients. The annual mortality was 6.5%, hospitalization 8%, and incidence of stroke 1%.
Conclusions:
In India, AF patients are younger and RHD is still the most frequent etiology. Almost two-third of the patients have persistent/permanent AF. At one-year follow-up, there is a significant mortality and morbidity in AF patients in India.
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