Epidemiological characteristics, management and outcomes of atrial fibrillation in young Tunisian patients: Results of the NATURE-AF registry

Introduction Atrial Fibrillation (AF) is recognized as the most frequent common sustained cardiac arrhythmia. The management of AF and its related complications is especially challenging. Data related to its clinical characteristics, management, and poor outcome in the young Tunisian patients remains scarce. Objective The data from this registry aimed to evaluate the epidemiological characteristics, management, and outcomes of AF in young Tunisian patients. Method NATURE AF is a prospective Tunisian registry that enrolled patients with AF from March 1 to May 31, 2017, with a one-year follow-up. Epidemiological characteristics and outcomes in young patients (< 75 years old) have been described. Results We included 696 elderly patients with AF. The mean age was 59 ± 6 years and patients were mostly women (51.4%). Obesity was the most common risk factor (76.1%), followed by hypertension (45%), diabetes mellitus (22.7%), dyslipidemia (20.8%) and smoking (18.7%). Chronic kidney disease was found in 7.6% of the population and chronic heart failure in 10.7%. The mean CHA2DS2-VASc score was 1.9 ± 1.5. AF was paroxysmal in 40.3% of patients. Non-valvular AF represented 78.4%. Most patients (66%) were put on VKA. The mean TTR was 49.2% ± 29.2% with 8.6% of patients having adequate anticoagulation with a TTR > 70%. Rhythm control was set out in 57.8% of patients. Thromboembolic complications were observed in 1.1% of patients, bleeding events in 6%, and 3.9% died. Conclusion AF is related to many comorbidities and complex medical histories. The NATURE AF Registry has provided systematic collection of contemporary data regarding epidemiological clinical characteristics and the management of AF in Tunisia in young patients. The quality of anticoagulation remained poor.