Atrial fibrillation and embolic complications.

Clinical records of 136 cardiac patients with atrial fibrillation (AF) followed in the cardiac clinic of the Black Lion Hospital were analysed. The mean age of the patients was 41 +/- 13 years, with a male to female ratio of 1.0:1.6. Rheumatic heart disease (RHD) was found in 66.3%, hypertension in 10.3%, cardiomyopathy in 8.8% and ischaemic heart disease in 6.6%. Embolic episodes occurred in 26 (19.1%) cases with five deaths. Twenty-one patients had cerebrovascular accident while five had femoral artery occlusion. The major cause of embolisation was rheumatic valvular heart diseases (65.5%), especially mitral stenosis. In order to reduce the high risk of systemic emboli, it is recommended that patients with AF and associated recent onset of congestive heart failure, previous history of thromboembolism and hypertension should be anticoagulated if there are no contraindications.