Clinical Factors Associated with Atrial Fibrillation in Congestive Heart Failure Patients Admitted to the University Teaching Hospital, Lusaka, Zambia

Introduction: Atrial fibrillation (AF) and Congestive Heart failure (CHF) have emerged as major global epidemics. Each of these conditions predisposes to the other, and their concomitant presence has additive adverse effects. This study examined the clinical factors associated with AF in CHF patients admitted to the University Teaching Hospital (UTH), Lusaka, Zambia.

Methods: This was a hospital-based cross-sectional study done in the admission wards of the UTH involving adult patients with the primary diagnosis of congestive heart failure. The data was collected from July 2014 to September 2014. A structured interview schedule was used to capture the socio-demographic and related historical data. Then all patients had a standard 12-lead ECG done on them to check for AF. Those participants with no AF on a standard 12-lead ECG had 24-hours ECG DR180+ Digital Recorder applied to try to pick-up paroxysmal AF. Finally all participants with AF were assessed for clinical factors (i.e. sex, age, BMI, smoking, excessive alcohol intake, hypertension, coronary artery disease, dilated cardiomyopathy, diabetes mellitus, and chronic lung disease). Pearson chi-square of independence of the data was used to analyze the data in SPSS® 20.0 to determine clinical factors of AF in CHF patients.

Results: A total of 49 patients were included in the study and 13 (26.5%) of them had AF, 7 diagnosed by standard ECG and 6 diagnosed by holter ambulatory ECG monitoring. The prevalence of AF in CHF was found to be strongly associated with age 65 years and above, obesity, smoking, excessive alcohol intake, hypertension, dilated cardiomyopathy, diabetes mellitus and chronic lung disease. These findings suggest the need for clinicians to consider full scale use of ambulatory ECG monitors in all CHF patients with the above conditions.