评价一组喀麦隆城市人群中首次心房颤动危机的管理。

Evaluation of the management of a first crisis of atrial fibrillation in a group of Cameroon's urban setting subjects.

机构信息

Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.

Cardiology Department, Yaoundé Central Hospital, Yaoundé, Cameroon.

出版信息

BMC Cardiovasc Disord. 2024 Aug 24;24(1):450. doi: 10.1186/s12872-024-04128-y.

DOI:10.1186/s12872-024-04128-y

PMID:39182048

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11344359/

Abstract

BACKGROUND

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. When atrial fibrillation is first diagnosed, it tends to be permanent and associated with significant morbidity and mortality. We aimed to study the management of a first episode of atrial fibrillation in a group of patients in Yaounde, Cameroon.

METHODS

We conducted a retrospective study with data collected from the Cardiology department of Yaounde Central Hospital and the internal medicine department of Yaounde General Hospital over five years (January 2017 to December 2021), for a duration of 4 months, from February 2022 to May 2022. All patients older than 15 years with a first episode of atrial fibrillation were included, and all patients with incomplete medical records were excluded. The association between different variables was assessed using a χ² test and logistic regression method with a significance threshold of p < 0.05.

RESULTS

Of the 141 patients recruited, the mean age was 68.5 ± 10.6 years. The sex ratio (M/F) was 0.7. The main associated factors and co-morbidities were hypertension in 70.2% (99) patients, heart failure in 36.9% (52) patients and a sedentary lifestyle in 33.3% (47) patients. The most common anticoagulant treatment was AntiVitamin K, used in 64.5% (91) of patients. Heart rate control was the most commonly used symptom control strategy in 85.1% (120) patients, mainly with beta-blockers in 52.5% (74). We found 1.4% (2) participants who were not treated with antithrombotics as recommended. Treatment of arrhythmia due to co-morbidities was not always recommended. The complication rate was 94.3% (133) patients. Control of the bleeding risk due to antithrombotic therapy and monitoring of anticoagulant therapy were not optimal. The heart rate control strategy had a higher success rate, and the sinus rhythm maintenance rate at one year was 61.7% (37) participants.

CONCLUSION

The management of a first episode of atrial fibrillation at Yaoundé's Central and General Hospitals is not always performed according to current recommendations and is far from optimal. However, nearly two out of three patients maintained sinus rhythm for one year.

摘要

背景

心房颤动（AF）是临床实践中最常见的心律失常。当首次诊断出心房颤动时，它往往是永久性的，并与显著的发病率和死亡率相关。我们旨在研究喀麦隆雅温得一组患者首次发生心房颤动的管理。

方法

我们进行了一项回顾性研究，数据来自雅温得中央医院心内科和雅温得综合医院内科五年（2017 年 1 月至 2021 年 12 月）的数据，持续 4 个月，从 2022 年 2 月至 2022 年 5 月。所有年龄大于 15 岁且首次发生心房颤动的患者均被纳入研究，所有病历不完整的患者均被排除在外。使用卡方检验和逻辑回归方法评估不同变量之间的关联，显著性阈值为 p < 0.05。

结果

在纳入的 141 名患者中，平均年龄为 68.5 ± 10.6 岁。男女比例（M/F）为 0.7。主要相关因素和合并症为高血压占 70.2%（99 例）、心力衰竭占 36.9%（52 例）和久坐不动的生活方式占 33.3%（47 例）。最常用的抗凝治疗是抗维生素 K，用于 64.5%（91 例）的患者。在 85.1%（120 例）的患者中，心率控制是最常用的症状控制策略，主要使用β受体阻滞剂占 52.5%（74 例）。我们发现有 1.4%（2 例）的患者未按推荐进行抗血栓治疗。并非总是建议对合并症引起的心律失常进行治疗。并发症发生率为 94.3%（133 例）。由于抗血栓治疗和抗凝治疗监测，对出血风险的控制并不理想。心率控制策略的成功率较高，一年后窦性节律维持率为 61.7%（37 例）。