Atrial Fibrillation in Primary Healthcare

Abstract

Introduction: Atrial fibrillation is an important health concerns, due to its increasing incidence with aging and association with other diseases. Patients with atrial fibrillation have 4-5 times the risk of stroke and about twice the risk of death in relation to those without atrial fibrillation.

Objective: To characterize patients with atrial fibrillation treated at Guanabo outpatient Polyclinic.

Methods: A retrospective, descriptive and cross-sectional study was carried out with all the patients admitted, with the aforementioned arrhythmia, in the municipal intensive care unit of Guanabo (eastern Havana, Cuba). Twenty-four months were reviewed (10 from 2017 and 2018, and the first four-month period of 2019). The variables studied were main diagnosis at admission, hemodynamic status, lethality, therapeutic strategy, and final behavior.

Results: Regarding their main diagnosis on admission, fibrillation accounted for 52% of cases, another entity plus electrocardiographic findings accounted for the rest; 6.5% arrived with hemodynamic instability. Two cases died, which resulted in a case fatality rate of 2.2%. Pharmacological cardioversion was used in 68 cases (75%). The most commonly used drugs were amiodarone, atenolol and digoxin. Electrical cardioversion was applied in only four of the six unstable cases. Fifty-eight percent were discharged home, 39% were remitted, and 70% had a stay between two and three hours.

Conclusions: The main diagnosis at admission was atrial fibrillation, with hemodynamic stability and low lethality. The therapeutic strategy consisted of amiodarone, atenolol and digoxin. The service showed high solving capacity. The average length of stay was two to three hours.