Description of Atrial Fibrillation in a Cardiology Department in Mahajanga, Madagascar

Introduction Despite the increasing development of research on atrial fibrillation (AF), epidemiologic data remain limited in certain regions, particularly Madagascar. Madagascar is a country with limited resources and data on the cardiovascular health of the population. Our objectives were to report the prevalence of AF and to describe patient characteristics. Materials and methods This was a retrospective descriptive study that included 103 patients with AF during their hospitalization at the cardiology department of the Mahavoky Atsimo University Hospital in Mahajanga between January 2015 and July 2023. Results The prevalence of AF was 5.27%. The mean age of the patients was 59.53 years (±17.88), and the sex ratio was 1.10. All patients were symptomatic, and dyspnea (53.40%; n = 55) was the main symptom. Signs of heart failure (HF) were observed in 70.87% of cases (n = 73). The majority of patients (87.38%; n = 90) had a CHA₂DS₂-VASc (congestive HF, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age 65-74 years, sex category) score ≥ 2, and of these, 10 patients were not anticoagulated. Vitamin K antagonists and direct oral anticoagulants were prescribed in 71.84% (n = 74) and 9.71% (n = 10) of cases, respectively. Rate control was the most commonly used therapeutic strategy. Spontaneous return to sinus rhythm occurred in 14 patients (13.59%). Twelve patients (11.65%) had a stroke, and one patient (0.97%) died during a mean hospital stay of 6.92 days (±4.7). Conclusions This study provides an overview of the situation in Madagascar. Management is far from meeting current recommendations for good practice, which is a major challenge.