Atrial Fibrillation at Hassan II Regional Hospital, Agadir, Morocco: Insights Into Presentation and Management

Background Atrial fibrillation (AF) is a common supraventricular arrhythmia marked by chaotic, uncoordinated atrial activity that impairs effective contraction. This hemodynamic inefficiency promotes intracardiac thrombus formation, making AF a major cause of ischemic cerebral events and other embolic events. Objectives The objective of our study is to describe the epidemiological, clinical, paraclinical, etiological, therapeutic characteristics, and outcomes of AF at Hassan II Regional Hospital in Agadir, Morocco and to compare findings with the available literature. Methods Our study consisted of a cross-sectional, retrospective, observational study including 111 patients hospitalized for AF in the Cardiology Department of Hassan II Regional Hospital Center (Agadir) over two years (June 1, 2021, to June 1, 2023). Descriptive analyses were performed using the Excel program. Results Our cohort included a total of 111 patients, with a male-to-female ratio of 0.94. The mean age was 63.2 years old. Diabetes and hypertension were the most prevalent risk factors (each 29.7%), and pre-existing heart disease was present in 63%, predominantly ischemic heart disease. Dyspnea was the leading presentation (81.1%). On admission, the mean heart rate was 117 beats per minute (bpm), and clinical signs of heart failure were observed in 71.1%. Electrocardiography showed left bundle branch block in 25.2% and signs of left ventricular hypertrophy in 27%; and chest imaging showed cardiomegaly in 59.5%. Transthoracic echocardiography revealed left atrial dilation in 71.2%, impaired left ventricular systolic function in 55%, and severe mitral stenosis in 17.1%. AF was valvular in 22.5%, while ischemic heart disease was the leading etiology (28.8%). A permanent AF pattern predominated (75.7%). Anticoagulation, guided by thromboembolic risk, was initiated in 90.1% of patients, with vitamin K antagonists (VKAs) used in 62.1%. Rhythm control was chosen in 18.9% versus rate control in 81.1%. The mean hospital stay was 10.3 days, and outcomes were favorable in 70.2%. Conclusion AF at Hassan II Regional Hospital in Agadir, Morocco, is characterized by a high comorbidity burden, frequent heart failure at presentation, substantial structural heart disease, and predominance of permanent AF. Anticoagulation was instituted in most patients, with rate control as the primary strategy. These findings underscore the need to strengthen early detection and optimize evidence-based management to prevent severe complications.