RELATION BETWEEN LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN DIFFERENT DISEASES

BACKGROUND: Atrial fibrillation is the most common cardiac dysrhythmia and left atrial size is an important factor in the development of atrial fibrillation.In the presence of atrial fibrillation an increase in left atrial size is associated with increased risk of stroke as well as increased morbidity and mortality.In this context, this study entitled "relation between left atrial size and atrial fibrillation in different diseases" was undertaken to study the left atrial size in different diseases causing atrial fibrillation and its relation to the atrial fibrillation.METHODS: A crosssectional study was done from March 2004 to February 2006 in all medical units of Basaveshwar teaching and general hospital and Government general hospital Gulbarga.70 cases of atrial fibrillation were studied in the present study.RESULTS: In the present study Atrial Fibrillation was common in >40 years age group (70%), left atrial enlargement was also more common in this age group (69.38%).Left atrial enlargement was seen in 70% of patients with Atrial Fibrillation.Rheumatic heart disease was the most common cause of Atrial Fibrillation (54.28%) and left atrial enlargement was seen in 92% of these patients with mean left atrial size of 58.92 mm.Next most common cause was coronary artery disease (20%) and left atrial enlargement was seen in 57.14% patients with a mean left atrial size of 39.5 mm.Left atrial size was normal in patients with thyrotoxicosis, congenital heart disease, lone Atrial Fibrillation and primary pulmonary hypertension.Left atrial enlargement was significantly associated with worsening of functional status (p<0.01),pulmonary arterial hypertension (p<0.005) and congestive cardial failure (p<0.02).17.14% of patients with Atrial Fibrillation had embolic complications like stroke, of them left atrial enlargement was seen in 83.33% patients.4.27% of patients with Atrial Fibrillation died during the hospital course, of them left atrial enlargement was seen in 66.66% patients.