Koju Shrestha Rojeena, Bista Durga, Shakya Rajani, Koju Rajendra Prasad, Gurung Ram Bahadur
Department of Pharmacy, Kathmandu University, Dhulikhel, Kavre, Nepal.
Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Cardiol Res Pract. 2024 Oct 28;2024:1759135. doi: 10.1155/2024/1759135. eCollection 2024.
Atrial fibrillation (AF) is a common morbid arrhythmia that can cause thromboembolic events such as stroke. Despite advancements in diagnostic technologies, a significant number of AF patients may remain undetected and undiagnosed, and these asymptomatic patients possess sufficient risk of cardioembolic stroke. Identifying such patients through appropriate screening techniques and timely initiation of systemic anticoagulation therapy is essential to prevent such life-threatening complications. The objectives of this study encompass screening of AF among residents of the Dhulikhel Municipality and identifying its prevalence, along with evaluation of stroke risk and use of antithrombotic therapy in patients confirmed with AF. All residents of four wards of Dhulikhel Municipality, aged 50 years and above ( = 2048), underwent one-time electrocardiogram (ECG) screening using a portable 12-lead ECG machine. The cardiologist checked the cardiogram, and suspected AF cases were referred to the hospital for further evaluation and appropriate management. They were followed up to find out information on disease confirmation and management. Out of 2048 participants, AF was detected in 16 participants, resulting in an overall prevalence of 0.78% (CI 0.4%-1.3%). The prevalence of AF was highest (2.98%) in population aged 80 years and above. Among individuals with AF, the median age was 71.5 (66.3-79.5) years, 50.0% were male and 75.0% had high stroke risk as indicated by a CHADS-VASc score ≥ 2. Among these patients, only 41.66% were treated with oral anticoagulants (OACs), while 58.34% were treated either with single or dual antiplatelet therapy (DAPT). This study provided important insight into the prevalence of AF at the community level. Many AF patients were at high risk of stroke, but the OAC use was less than 50%. Screening of AF needs to be carried out on a larger scale in Nepal for early detection and timely management of the disease.
心房颤动（AF）是一种常见的病态心律失常，可导致血栓栓塞事件，如中风。尽管诊断技术有所进步，但仍有相当数量的房颤患者可能未被发现和诊断，而这些无症状患者存在发生心脏栓塞性中风的足够风险。通过适当的筛查技术识别此类患者并及时启动全身抗凝治疗对于预防此类危及生命的并发症至关重要。本研究的目的包括在杜利凯尔市居民中筛查房颤并确定其患病率，同时评估中风风险以及确诊房颤患者的抗栓治疗使用情况。杜利凯尔市四个选区所有年龄在50岁及以上（n = 2048）的居民使用便携式12导联心电图机进行了一次心电图（ECG）筛查。心脏病专家检查心电图，疑似房颤病例被转诊至医院进行进一步评估和适当管理。对他们进行随访以了解疾病确诊和管理的信息。在2048名参与者中，16名参与者检测出房颤，总体患病率为0.78%（置信区间0.4%-1.3%）。80岁及以上人群的房颤患病率最高（2.98%）。在房颤患者中，中位年龄为71.5（66.3-79.5）岁，50.0%为男性，75.0%的CHADS-VASc评分≥2，表明中风风险高。在这些患者中，只有41.66%接受了口服抗凝剂（OAC）治疗，而58.34%接受了单药或双联抗血小板治疗（DAPT）。本研究为社区层面房颤的患病率提供了重要见解。许多房颤患者中风风险高，但OAC的使用率不到50%。尼泊尔需要更大规模地开展房颤筛查，以便早期发现和及时管理该疾病。
