PREVALANCE, OUTCOME AND ASSOCIATED FACTORS OF ATRIAL FIBRILLATION IN ADULT HEART FAILURE PATIENTS ADMITTED TO HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL BETWEEN SEPTEMBER 2019-2022, HARAR, EASTERN ETHIOPIA

Abstract

: Heart failure and Atrial fibrillation are two major cardiovascular problems worldwide that frequently coexist, predispose to each other, complicate treatment course and prognosis of each other. Improvement in patient quality of care and advancement in treatment options of atrial fibrillations in heart failure could reduce mortality. However, Prevalence of atrial fibrillation , in-hospital mortality and Predicting factors in admitted adult heart failure patients were not well defined at Hiwot Fana Special ized University Hospital, Eastern Ethiopia . Objective: The study aimed to determine prevalence , clinical outcome and associated factors of atrial fibrillation in admitted adult heart failure patients at Hiwot Fana Specialized University hospital be tween September 1-2019-2022. Methods: Hospital-based cross-sectional study was conducted and 227 adult heart failure patients were selected by systematic random sampling methods. The data was collected by reviewing medical records of patients .The data was tabulated, cleaned ,categorized and entered in to SPSS version 29 for analysis. Continuous variables have been expressed as mean ± standard deviation.Categorical and discrete varia bles have been expressed as frequency and percentage. Mantel-haenzel chi square also used to to deter mine the association of atrial fibrillation with clinical outcome and possible risk factors odds ratio and CI .Wald test and mann-whitney test was also used to examine the proportional and mean difference respectively on basis of AF .The margin of error accepted was set to be 5%.So,the p -value considered significant if <0.05 and CI also considered significant if doesn‟t cross over or includes 1. Result :In this study total of 227 admitted heart failure patients were included, Atrial fibrillation was identified in 30.4% and increased significantly in those with RVHD 43.8% OR 3.222 95% CI(1.771- 5.857) p<0.001, EF >40% 34.4% OR 2.72 95%(0.959-7.48) P=0.012. The stroke was seen in 5.3% of patients of which 80% was attributed to atrial fibrillation with OR 5.049 (1.467-3.696) P=0.008 . Car diogenic shock was seen in 9.3% of which 21.4% was attributed to atrial fibrillation OR 1.273(0.451- 3.592) P=0.649 . 14.1% of patients were died in the hospital of which 32% was attributed to atrial fibril lation OR 1.4710.661-3.277 P=0.344. Conclusion: Atrial fibrillation was identified in one third of ad mitted heart failure patients and significantly increased in those with underlying RVHD and Diastolic dysfunction(EF>40%). Atrial fibrillation was significantly associated with increased odds of stroke however, Atrial fibrillation were not significantly associated with increased risk of cardiogenic shock and mortality.Improvement in stroke preventive strategy focusing on heart failure with atrail fibrilla tion and advancement in AF screening as well therapeutic strategy are recommended.