Atrial Fibrillation: Epidemiological, Clinical, Paraclinical, and Therapeutic Aspects in the Cardiology B Department of the Brazzaville University Hospital (Republic of Congo)

Introduction: Atrial fibrillation (AF) is the most frequent cardiac arrhythmia encountered in clinical practice. The aim of this study was to assess the frequency of AF and to describe its epidemiological, clinical, paraclinical, and therapeutic characteristics in a Congolese hospital setting. Patients and Methods: This was a retrospective, descriptive study conducted in the Cardiology Department B of the Brazzaville University Hospital from January 1, 2022, to December 31, 2024. Medical records of patients hospitalized for atrial fibrillation were included. Results: Among 1550 patients admitted to the Cardiology B Department, 65 cases of AF were identified (4.2%). There were 41 women (63%). The mean age was 66.7 ± 15.4 years (range: 24 - 101 years). Past medical history included hypertension (61.5%), type 2 diabetes mellitus (12.3%), and ischemic stroke (6.1%). Dyspnea was present in 93.8% of cases. The mean heart rate was 101.5 ± 28.1 beats per minute. Clinical presentations included heart failure (81.5%) and left hemibody neurological deficit (9.2%). Electrocardiography revealed fine atrial fibrillation in 89.2% of cases. AF was permanent in 58.5%, persistent in 21.5%, and paroxysmal in 20%. Echocardiography showed left atrial enlargement in 36.9%, impaired left ventricular systolic function in 21.5%, reduced function in 20%, and preserved function in 4.6%. The predominant cardiac etiologies were hypertension (83%), including 61.5% as a cardiovascular risk factor and 21.5% as hypertensive heart disease, rheumatic valvular heart disease and dilated cardiomyopathy (27.7% each), and ischemic heart disease (6.1%). Treatment included digitalis (58.5%), beta-blockers (43.5%), and amiodarone (10.7%). Anticoagulant therapy was used in 75.4% of patients: vitamin K antagonists (58.5%) and direct oral anticoagulants (16.9%). In-hospital mortality occurred in six patients (9.2%). Conclusion: Atrial fibrillation remains frequent in the Congolese hospital setting and is mainly dominated by hemodynamic complications. Therapeutic management is essentially based on heart rate control and prevention of complications.