Indian Heart Journal (Jan 2017)

Clinical presentation, management, and outcomes in the Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF) registry

  • A. Vora,
  • A. Kapoor,
  • M. Nair,
  • Y. Lokhandwala,
  • C. Narsimhan,
  • A.G. Ravikishore,
  • S.K. Dwivedi,
  • N. Namboodiri,
  • R. Hygriv,
  • A. Saxena,
  • A. Nabar,
  • S. Garg,
  • N. Bardoloi,
  • R. Yadav,
  • A. Nambiar,
  • U. Pandurangi,
  • D. Jhala,
  • A. Naik,
  • Nagmallesh,
  • S. Rajagopal,
  • R. Selvaraj,
  • V. Arora,
  • A. Thachil,
  • J. Thomas,
  • G. Panicker

DOI
https://doi.org/10.1016/j.ihj.2016.06.006
Journal volume & issue
Vol. 69, no. 1
pp. 43 – 47

Abstract

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Aim: A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes. Methods: A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed. Results: The average age of Indian AF patients was 54.7 years. There was a marginal female preponderance – 51.5% females and 48.5% males. At baseline, 20.4% had paroxysmal AF; 33% had persistent AF; 35.1% had permanent AF and 11% had first AF episode. At one-year follow-up, 45.6% patients had permanent AF. Rheumatic valvular heart disease (RHD) was present in 47.6% of patients. Hypertension, heart failure, coronary artery disease, and diabetes were seen in 31.4%, 18.7%, 16.2%, and 16.1%, respectively. Rate control was the strategy used in 75.2% patients, digoxin and beta-blockers being the most frequently prescribed rate-control drugs. Oral anticoagulation (OAC) drugs were used in 70% of patients. The annual mortality was 6.5%, hospitalization 8%, and incidence of stroke 1%. Conclusions: In India, AF patients are younger and RHD is still the most frequent etiology. Almost two-third of the patients have persistent/permanent AF. At one-year follow-up, there is a significant mortality and morbidity in AF patients in India.

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