Co-existence of ischemic stroke in Rheumatic and non-rheumatic atrial Fibrillation in a tertiary care teaching hospital of Western Nepal

  • Ram Chandra Kafle Manipal College of Medical Sciences http://orcid.org/0000-0002-9840-8009
  • Girija Shankar Jha Cardiology unit, Dept. of Internal Medicine
  • Navaraj Paudel Cardiology unit, Dept. of Internal Medicine
  • Vijay Madhav Alurkar Cardiology unit, Dept. of Internal Medicine
Keywords: Atrial Fibrillation, Risk factors, Rheumatic heart disease, Stroke

Abstract

Background & Objectives: Stroke is a major public health burden worldwide leading to long-term morbidity and even mortality. Atrial fibrillation (AF) is the most common sustained arrhythmia and is an independent factor to increase risk of ischemic stroke. The risk of stroke further enhanced in rheumatic atrial fibrillation and affects younger population of developing countries.  The study has aimed to find out frequency of co-existence of stroke in AF and secondarily to look for age distribution of stroke and risk factors of AF.

Materials & Methods: A retrospective analysis of trans-thoracic echocardiographic records of patients from 1st June 2009 to 31st June 2016 was done. Data were collected in a pre-structured proforma and analyzed.

Results: Among 15767 echocardiographies, 577 (3.65%) cases were recorded to have atrial fibrillation. Mean age 65(±15) years ranging from 14 to 100 years. Rheumatic heart disease was the second most common cause of atrial fibrillation after hypertension. The co-existence of ischemic stroke was seen in 87(15.07%) cases with male to female ratio of 1:1.3. The proportion of stroke in rheumatic Atrial fibrillation was 21(18.75%) which was higher than in non-Rheumatic atrial fibrillation 66(14.2%).

Conclusion: Rheumatic heart disease is contributing as second most common cause of atrial fibrillation after hypertension, nearly one fourth of total stroke and most common (93%) cause of stroke below the age of 45 years. Preventive strategies aimed at health awareness about rheumatic fever, screening programs at community level, early detection and treatment for hypertension and Rheumatic heart disease can contribute in reduction of stroke burden. 

Downloads

Download data is not yet available.
Abstract
690
PDF
429

Author Biographies

Ram Chandra Kafle, Manipal College of Medical Sciences

Cardiology unit, Dept. of Internal Medicine

Assistant Professor

Girija Shankar Jha, Cardiology unit, Dept. of Internal Medicine
Assistant Professor
Navaraj Paudel, Cardiology unit, Dept. of Internal Medicine
Assistant Professor
Vijay Madhav Alurkar, Cardiology unit, Dept. of Internal Medicine
Assistant Professor
Published
2017-12-20
How to Cite
Kafle, R., Jha, G., Paudel, N., & Alurkar, V. (2017). Co-existence of ischemic stroke in Rheumatic and non-rheumatic atrial Fibrillation in a tertiary care teaching hospital of Western Nepal. Journal of College of Medical Sciences-Nepal, 13(4), 388-391. https://doi.org/10.3126/jcmsn.v13i4.18485
Section
Original Articles