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Atrial Fibrillation in Africa: Clinical Characteristics, Prognosis and Adherence to Guidelines in Cameroon

Author(s): M. Ntep Gweth*1, M. Zimmermann2, A. Meiltz2, S. Kingue3, P. Ndobo1, P. Urban2, A. Bloch2
Affiliation(s): 1Service de cardiologie, Hôpital Central, Yaoundé, Cameroon, 2Département cardiovasculaire, Hôpital de La Tour, Meyrin, Switzerland, 3Service de cardiologie, Hôpital Général, Yaoundé, Cameroon
Keywords: Atrial fibrillation; Africa; prognosis; guidelines; anticoagulation

The purpose of this prospective study was to characterise the clinical profile of patients with AF in the urban population of a Sub-Saharan African country and to assess how successfully current guidelines are applied in that context.


This prospective study involved 10 cardiologists in Cameroon. Enrolment started on 01.06.2006 and ended on 30.06.2007. Consecutive patients were included if they were >18 years and AF was documented on an ECG during the index office visit.


In this survey, 172 patients were enrolled (75 male; 97 female; mean age 65.8 ± 13 years). The prevalence of paroxysmal, persistent and permanent AF was 22.7%, 21.5% and 55.8%, respectively. Underlying cardiac disorders, present in 156/172 patients (90.7%), included hypertensive heart disease (47.7%), valvular heart disease (25.6%), dilated cardiomyopathy (15.7%) and coronary artery disease (6%). A rate-control strategy was chosen in 83.7% of patients (144/172) and drugs most commonly used were digoxin and amiodarone. The mean CHADS2 score was 1.9 ± 1.1 and 158/172 patients (91.9%) had a CHADS2 score ≥ 1. Among patients with an indication for oral anticoagulation (OAC), only 34.2% (54/158) actually received it. During a follow-up of 318 ± 124 days, 26/88 patients died (29.5%), essentially from a cardio-vascular cause (15/26). Eleven patients (12.5%) had a non lethal embolic stroke and 23 (26.1%) had symptoms of severe congestive heart failure.

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