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ORIGINAL ARTICLE
Year : 2018  |  Volume : 31  |  Issue : 2  |  Page : 387-394

Incidence of atrial fibrillation in ischemic and nonischemic dilated cardiomyopathy


1 Cardiology Department, Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
2 Cardiology Department, Al Nasr Hospital, Branch of Cairo, Health Insurance Commission, Cairo, Egypt

Correspondence Address:
Kareem M AlAraby
Cardiology department, Al Nasr Hospital, Branch of Cairo, Health Insurance Commission, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_644_16

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Objective The aim of this study was to identify the incidence of atrial fibrillation (AF) in ischemic dilated cardiomyopathy (IDCM) and nonischemic dilated cardiomyopathy (NIDCM). Background AF is a common arrhythmia and is associated with an increased risk for embolic events, congestive heart failure, and total mortality. It lowers the quality of life and has been shown to be associated with worsening of outcome in patients with congestive heart failure of different etiologies. Materials and methods Patients were recruited during scheduled outpatient visits to the outpatient clinic in the Menofia University Hospital and Health Insurance Hospital, over the period from July 2015 to March 2016. All patients underwent full physical examination, and ECG, echocardiogram, and coronary angiography were performed to differentiate between IDCM and NIDCM. Results Totally, 50 patients had dilated cardiomyopathy (DCM) with left ventricular dysfunction. They were classified into two groups: the NIDCM group (20 patients) and the IDCM group (30 patients). AF was found to be more frequent in IDCM patients than in NIDCM patients (P = 0.006). Dyslipidemia (P = 0.002), diabetes mellitus (DM) (P = 0.05), and the mean left atrial (LA) diameter (5.127 ± 0.798) (P = 0.03) were statistically significant in IDCM patients. The univariate analysis identified the following as predictors of AF incidence: DM (P = 0.006), dyslipidemia (P = 0.016), left ventricular end diastolic diameter (P = 0.022), LA diameter (P = 0.000), and IDCM (P = 0.006). The multivariate regression analysis identified that DM, dyslipidemia, and LA diameter (>4.8 cm) had a more independent predictor value of AF incidence among DCM patients despite etiological cause. Conclusion The incidence of AF is more frequent in IDCM than in NIDCM patients. There is no significant difference between the two groups as regards age, sex, BMI, and hypertension. LA dilatation is more significant in IDCM. DM, dyslipidemia, and dilated LA proved to be independent predictors of AF in DCM patients.


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