Prevalence and characteristics of valvular heart disease of patients with atrial fibrillation: Results from the NATURE AF registry

Background With the aging population and associated prevalence of other cardiovascular diseases, the burden of atrial fibrillation (AF) is projected to increase. However there is a lack about the actual epidemiological characteristics of AF in Tunisia and particularly concerning valvular etiologies. Therefore, a national Tunisian registry was recently conducted to enlighten theses issues. Purpose To describe the prevalence and characteristics of patients with valvular AF recruited from the prospective NATURE AF registry (NAtional TUnisian REgistry of Atrial Fibrillation). Material and methods Between March and June 2017, we prospectively registered information of 912 patients with a recently diagnosed AF. Patients with valvular heart disease were picked. Demographics, clinical and etiological characteristics as well as arrhythmia management strategies were recorded. Results Two hundred and twelve patients with a mean age of 64.1 ± 14.9 years old presented with valvular AF (23.2%). Sixty-three percent of the population were women. Persistent AF was predominant in 47.2% of patients. Paroxystic and permanent AF were recorded in 17.9% and 34.9% of cases respectively. After an etiological check up, mitral valvulopathy was diagnosed in the majority of patients (90.1%) with 28.3% of mitral stenosis and 36.6% of mitral regurgitation at least grade 2. Aortic valvuolopathy was seen in 37.7% of cases: Twenty-one percent of them had aortic stenosis and 28.8% had aortic regurgitation. A rate control strategy was adopted in the majority of cases (67.5%) while 28.3% of patients benefited from a rhythm control strategy. Conclusion The results of this registry underline the demographic change of the Tunisian population showing a decrease in valvular etiology of AF comparing to older national studies with a remaining predominance of mitral valvulopathy.