Magnitude of Atrial Fibrillation and Associated Factors among Adult Cardiac Patients At Ambo University Referral Hospital, West Shoa, Ethiopia

Abstract

Background: Atrial fibrillation is the most common arrhythmia in the world. Its incidence and prevalence have increased over the last 20 years and will continue to increase over the next 30 years, becoming one of the largest epidemics challenges. Its presence is linked to a notable degree of morbidity and mortality, thereby posing a considerable burden on patients, public health, and healthcare economy. There is limited data on atrial fibrillation in Ethiopia. Objective: To determine magnitude of atrial fibrillation and associated factors among adult cardiac patients on at Ambo university referral hospital, West Shoa, Ethiopia, 2024 Methods: An Institution based cross sectional study was conducted between September 2, 2024- January 30, 2025 on 376 cardiac patients that were selected by systematic random sampling technique. Data were collected using structured checklist through face-to-face interview, chart review and anthropometric measurement. The collected data was entered in to Epidata version 3.1, and then exported to SPSS version 27 for analysis. Bivariable logistic regression analysis was used to identify candidate variable for multivariable logistic regression. Variables that showed association at p value<0.25 in bivariable logistic regression analysis was selected for multivariable logistic regression. The possible effects of confounders will be controlled through multivariable logistic regression analysis to identify the predictor of the outcome variables. Statistical significance was declared at p value< 0.05 then interpreted using AOR with its respective 95% CI. Result: In this study, overall prevalence of atrial fibrillation was found to be 29.8% (95% CI:25.2%-34.7%). Factors including age >60 years (AOR=3.04, 95% CI:(1.07-8.66)) with p value .037, Heart failure (AOR=6.72, 95% CI:(3.12-14.44)) with p value <.001, ischemic heart disease (AOR=3.83, 95% CI:(1.40-10.44)) with p value .009, valvular heart disease (AOR=3.53, 95% CI:(1.58-7.92)) with p value .002, hypertensive heart disease (AOR=6.92, 95% CI:(2.02-23.73)) with p value .002, Pulmonary hypertension (AOR=8.86, 95% CI:(3.37-23.27)) with p value <.001, hypertension (AOR=.04, 95% CI:(.01-.12)) with p value <.001, physical inactivity (AOR=4.21, 95% CI:(1.99-8.92)) with p value <.001, CHA2-DS2-VASc score (AOR=3.75, 95% CI:(1.46-9.67)) with p value .006, Betablocker use (AOR=3.02, 95% CI:(1.52-6.02)) with p value .002, , and Statin use (AOR=.16, 95% CI:(.06-.43)) with p value <.001 were found to be statistically significant factors associated with atrial fibrillation. Conclusion and recommendation: In this study the overall prevalence of atrial fibrillation was 29.8%. Factors associated with AF were age > 60 years, Heart failure, ischemic heart disease, valvular heart disease, hypertensive heart disease, Pulmonary hypertension, hypertension, physical inactivity, CHA2-DS2-VASc score > 2, use of Betablocker and Statin. Therefore, optimizing lifestyle modifications, such as physical activity, can reduce atrial fibrillation risk, and early screening and treatment of at-risk patients can minimize mortality and morbidity.