Clinical and pathogenetic characteristics and management of patients with atrial fibrillation in a cardiology department at the present time

Aim. To assess clinical and pathogenetic characteristics of patients with atrial fibrillation (AF) hospitalized in cardiology department of the regional clinical hospital, and to clarify the related management strategy.

Material and methods. A total of 1164 patients were hospitalized in cardiology department of N.A. Semashko Nizhny Novgorod Regional Clinical Hospital in 2017, of which 331 (28,4%) had AF. These patients were included in the study. We analyzed history data of all patients, standard diagnostic tests were carried out. The CHA₂DS₂-VASc score was used to determine the risk of thromboembolic events, and the HASBLED score — to determine the bleeding risk.

Results. The average age of patients was 63,2±10,0 years. In all patients, AF was diagnosed before admission to the hospital. All patients were hospitalized according to hospital waiting lists due to underlying diseases. The most common diseases were coronary artery disease, mainly in combination with hypertension, inflammatory and dystrophic myocardial disorders. Twenty-four patients were hospitalized due to heart failure progression. Nonvalvular AF prevailed among patients. Most patients had a permanent AF (58,3%), the second place took pa - roxysmal AF (36,8%). Much less frequently (4,9%), a persistent AF was observed. Stratification of risk factors for stroke, systemic thromboembolism, as well as for bleeding when indicated for anticoagulant therapy was carried out. Based on the results, oral anticoagulants were indicated for 260 (78,8%) of participants, while only 38,8% received them before hospitalization.

Conclusion. Among patients hospitalized in the cardiology department, 28,4% had AF. The most common was nonvalvular AF, associated mainly with coronary artery disease, essential hypertension and their combination. Anticoagulant therapy was indicated for 78,8% of patients, while only 38,8% received it before. This requires further optimization of management of AF patients.

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