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Clinical characteristics and management practice among patients diagnosed with atrial ibrillation in Benghazi Libya, A cross sectional study

Introduction: There are no data so far regarding the frequency and outcome of the different types of atrial fibrillation (AF) in the clinical setting for Libyan patients. Furthermore, it is unknown whether the actual clinical management and therapy of AF in Libya conform to the international guidelines. The aim of this study was to determine the frequency, demographic, and clinical characteristics of AF patients. Patients and Methods: Three hundred patients attending the outpatient clinic and cardiology department at Benghazi Medical Center and National Cardiac Center between May 2020 and October 2020 were included. Patients' data were obtained through medical records using the chart review. Patients were categorized into a clinical type of AF, based on the physician's perception of the AF at the time of presentation. Results: Three hundred patients with an established diagnosis of AF were enrolled, including 210 (70%) females and 90 (30%) males. The mean age at the time of diagnosis was 49.5 ± 21.5 years, with an age range of 29–79 years. Of them 139 (46.3%) were diagnosed as permanent AF, 132 (44%) paroxysmal AF, while new-onset AF was diagnosed in 29 (9.7%). The three clinical categories of AF were enrolled under the care of both cardiologists and internal medicine physicians, but permanent AF patients were more often enrolled under the care of a cardiologist. Patients with permanent AF were older compared with those with paroxysmal subtype (61.8 ± 9 and 50.1 ± 12, respectively), with significant female predominance (P = 0.03), and more often had coronary artery disease (CAD), valvular heart disease, and a previous stroke/TIA (P = 0.01, P = 0.124, and P = 0.002, respectively). Diabetes was the most prevalent associated medical condition, followed by hypertension and hyperlipidemia. CAD was diagnosed among 122 patients. Of permanent AF patients, 28 patients (20.1%) previously suffered from a stroke, mostly TIA, in contrast to 14 patients (10.6%) of the other AF patients. Conclusion: Our AF patients were characterized by an unfavorable cardiovascular risk profile. We recognize a lower rate of oral anticoagulation prescription, which needs further evaluation.