PREVALENCE AND ASSOCIATED FACTORS OF ATRIAL FIBRILLATION IN RHEUMATIC HEART DISEASE PATIENTS AT THE ADULT CARDIOLOGY CLINIC UNIVERSITY OF GONDAR COMPREHENSIVE SPECIALIZED HOSPITAL, GONDAR, NORTHWEST ETHIOPIA, FROM 2017 TO 2024

Abstract

Background: Rheumatic fever (RF) is an autoimmune condition that follows an infection of the throat caused by group A β-hemolytic streptococcus (GAS). Recurrent episodes of RF can result in ongoing damage to the heart valves, leading to rheumatic heart disease (RHD), which can further cause complications such as atrial fibrillation and heart failure. According to the World Health Organization (WHO), RF and RHD affect approximately 15.6 million people worldwide, with 282,000 new cases and 233,000 deaths each year. Atrial fibrillation is a common complication of RHD, contributing to significant morbidity and mortality. Objective: To assess Prevalence and associated factors of Atrial Fibrillation in Rheumatic Heart Disease Patients at University of Gondar Comprehensive specialized Hospital, Northwest Ethiopia, from September 2017 to September 2024 Method: A hospital-based retrospective cross-sectional study was conducted by reviewing the medical records of RHD patients at the adult cardiology clinic who underwent echocardiography from September 2017 to September 2024. A total of 280 patients were included, and data were collected by systematic random sampling. The data were coded and entered into EpiData version 4.6, then analyzed using Stata version 17. Bivariate and multivariate logistic regression analyses were performed, with a significance level set at a p-value < 0.05 and a 95% confidence interval. Results: Among 280 patients more than 2/3 were females and the mean age was 33(11).The prevalence of AF in RHD patients was found to be 39.3 %( 95% CI: 33.7%-45.15%).Being age >50 years (AOR=4.23, 95% CI: 1.09-16.27), New York Heart Association (NYHA) class 3and4 (AOR=1.95, 95% CI: 1.02-3.72), severe MS (AOR=3.1, 95% CI: 1.35-6.98) and LA enlargement(AOR=2.9, 95% CI: 1.08-7.74) were significantly associated with AF. Conclusion: The prevalence of atrial fibrillation (AF) in rheumatic heart disease patients was 39.3%, with key risk factors including older age, advanced NYHA class, severe mitral stenosis, and enlarged left atrial diameter