ATRIAL FIBRILLATION IN WEST AFRICA: LESSONS GLEANED FROM THE IBADAN AF PROJECT.

Abstract

Introduction/Background: There is still little data on clinical profile and atrial fibrillation (AF) characteristics in West Africa. Traditionally the risk factor for chronic AF in the sub-region is chronic rheumatic heart disease. However, with the rapid demographic and epidemiologic transition in the sub-region, the risk factors, clinical profile, and complications of AF appear to be changing. Objective(s): The aim of this study is therefore to describe the contemporary clinical profile and characteristics of AF in Ibadan, Nigeria. Methods: This is a prospective observational study that commenced on June 1, 2016. All adults aged 18 years and above with electrocardiographic diagnoses of AF were included in the study. The case report form included sociodemographic data, clinical information, risk factors, management, and clinical outcomes. Results: Three hundred and fifty-seven (357) patients were recruited (mean age 63.4(14.6) years, males 189 (52.9%). In terms of clinical subtypes, the distribution is as follows: permanent- 219(61%), persistent - 88(25%), paroxysmal- 51(14%) There was none with lone AF in this cohort. 112 (31%) had previous AF. The common co-morbidities are hypertension, heart failure, and valvular heart disease. 318(89%) had a CHA2D2VASC score of 2 or more. In terms of management, rate control was the commonest strategy (64.4%), and beta-blockers and/or digoxin were commonly prescribed. 73(64.6%) were on anticoagulation, but only 30% achieved adequate anticoagulation. Conclusions: Non-rheumatic, non-atherosclerotic conditions are the common risk factors for AF in Ibadan, Nigeria. Measures to prevent stroke as well as control of risk factors for AF should be emphasized. Keywords: Atrial fibrillation, lessons gleaned, Ibadan AF project.