Introduction

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with an estimated global prevalence of 37.574 million cases (0.51% of the world population) ¹

AF has a heterogeneous clinical presentation and can be asymptomatic.  It is often associated with heart disease but may occur in patient with no other detectable cardiac disease.¹

By convention, the term "nonvalvular AF" is restricted to cases in which the rhythm disturbance occurs in the absence of mitral valve disease, a prosthetic heart valve or mitral valve repair.⁶

AF  has  significant  morbidity  and  mortality  due  to  the occurrence  of  both  hemodynamic  impairment  and thromboembolic  events. 

The hemodynamic impairment and rhythm disturbances may be symptomatic and can lead to a decrease in the quality of life.  However, most of  the  mortality  and  functional impairment associated with AF is due to ischemic stroke and  other  systemic emboli.  The  frequency  of ischemic stroke  and  systemic  embolism  in  patients  with nonvalvular  AF is  approximately  5%  per  year  that  is about  2  to  7  times  the  rate  for  patient  without  AF. ²

Mortality in AF patient is double that of patients in normal sinus rhythm this islinked with the severity of the underlying  heart disease.³

The risk of stroke and systemic embolism in patients with AF is determined by patient risk factors. Risk factors for stroke and systemic embolism in patient with nonvalvular AF are a history of previous stroke of transient ischemic attacks (TIA), a history of  hypertension, left  ventricular dysfunction (LVD) or congestive heart failure (CHF), age (over  75years),  diabetes  mellitus  and  coronary  artery disease.⁴

Patients without any of these risk factors i.e.  lone AF, have  a  more  favourable  prognosis,  In  the  Framingham heart study, patient with rheumatic heart disease and AF had a 17- fold increased risk of stroke compared with age matched  controls  and  the  attributed  risk  was  5  time greater than in those with non-rheumatic AF.⁵

The aim of the present   was  to  study  the epidemiology AND clinical profile of nonvalvular atrial fibrillation

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Dr Nuvvula Siva Krishna MD; (DM)