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. 2023 Aug 17;23(1):403.
doi: 10.1186/s12872-023-03427-0.

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: a prospective cohort study

Clara Damascene Makatu #  1 , Reuben Kato Mutagaywa #  2   3 , Ponsian Peter  4 , Aileen Barongo  5 , Engerasiya Kifai  3
Affiliations

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: a prospective cohort study

Clara Damascene Makatu et al. BMC Cardiovasc Disord. .

Abstract

Background: Arrhythmia is a known complication of rheumatic heart disease (RHD). It is critical to recognize arrhythmias early on so that prompt preventative actions and vigilant monitoring may be considered while treating these patients.

Aim: This study aimed at determining the prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among RHD patients attending Jakaya Kikwete Cardiac Institute (JKCI).

Methodology: Hospital-based cross-sectional study was conducted among 390 patients with an echocardiographic diagnosis of RHD aged 18years and above attending JKCI. Demographic and clinical information was documented. Echocardiography, a resting electrocardiography and 24 h ambulatory Holter monitoring electrocardiography were done. Chi square test was used to determine association between variables and those with a p value ≤ 0.2 were entered in a multivariate logistic regression analysis to determine the independent factors associated with arrhythmias. P value of < 0.05 was considered statistically significant. The receiver operating curve was used to determine the critical point for left atrial size beyond which arrhythmias develop.

Results: A total of 390 patients were included in the analysis. The median age was 39 years interquartile range (IQR 30-52). Females were 257/390 (65.9%). Asymptomatic patients were 208/390 (53.3%). Most patients belonged to New York heart Association (NYHA) functional class I&II 247/390 (62.1%). The most common valve lesion was mitral stenosis 228/390 (58.5%). Arrhythmias were found in 276/390 (70.77%) patients, of which 193/390 (49.5%) patients were from resting electrocardiography (ECG) and 88/197 (44.7%) patients from holter ECG. Independent factors for arrhythmias were, NYHA functional class III&IV (a0R 4.67, 95% CI 1.82-12.00 p = < 0.01) and severe left atrial diameter enlargement (aOR 7.28, 95% CI 3.17-16.70 p = < 0.01). The critical point beyond which arrhythmias develop was found to be left atrium diameter > 48 mm.

Conclusion: We found a high prevalence of arrhythmias among patients with RHD. The independent predictors of arrhythmias were left atrium dilatation and NYHA functional class III-IV. We recommend close monitoring for arrhythmias among RHD patients in sinus rhythm with higher NYHA functional class and dilated left atrium.

Keywords: Arrhythmias; Electrocardiography; Heart failure; Left atrium; Mitral stenosis; Rheumatic heart disease.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence and types of arrhythmias
Fig. 2
Fig. 2
Cut off prediction valueofleft atrium sizefor arrhythmias development
See this image and copyright information in PMC

References

    1. Singh M, Malhotra P, Thakur JS. Rheumatic heart disease in developing countries [16] Lancet. 1997;349(9066):1700. doi: 10.1016/S0140-6736(05)62673-6. - DOI - PubMed
    1. Itzikowitz G, Prendergast EA, Prendergast BD, Zühlke L. Acute rheumatic fever and rheumatic heart disease. Hear Valve Dis State Art. 2019;(November 2001):163–75.
    1. Watkins DA, Beaton AZ, Carapetis JR, Karthikeyan G, Mayosi BM, Wyber R, et al. Rheumatic Heart Disease Worldwide: JACC Scientific Expert Panel. J Am Coll Cardiol. 2018;72(12):1397–416. doi: 10.1016/j.jacc.2018.06.063. - DOI - PubMed
    1. Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, et al. Global, Regional, and National Burden of Rheumatic Heart Disease, 1990–2015. N Engl J Med. 2017;377(8):713–22. doi: 10.1056/NEJMoa1603693. - DOI - PubMed
    1. Alam S. Correlation of paroxysmal and persistent cardiac arrhythmias with clinical and echocardiographic parameters in patients of rheumatic fever and Rheumatic Heart Disease. 2020;(June 2019).

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