Clinical Profile, Etiological Spectrum, and Management Patterns of Atrial Fibrillation in a Tertiary Care Hospital: A Prospective Observational Study

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, associated with substantial morbidity and mortality due to stroke and heart failure. Understanding its clinical and etiological patterns within regional populations is essential for improving management strategies. Aim: This study aims to evaluate the demographic profile, etiological spectrum, clinical characteristics, and management patterns of patients diagnosed with AF in a tertiary care hospital. Materials and Methods: This prospective, hospital-based observational study was conducted at a single-center tertiary hospital in Wardha, India, from January 2023 to June 2025. Sixty-eight consecutive patients with electrocardiographic-confirmed AF were enrolled. Demographic, clinical, echocardiographic, and treatment data were analyzed using Chi-square and Fisher’s exact tests, with 95% confidence interval (CI) and P < 0.05 considered statistically significant. Results: AF was most prevalent among patients aged 61–80 years (55.9%; 95% CI 43.1–68.0) and showed a slight female predominance (51.5%). Hypertension (44.1%) and heart failure (44.1%) were the most common comorbidities. Nonvalvular AF was more frequent (55.9%), whereas rheumatic heart disease accounted for 80% of valvular AF, showing significant female predominance ( P = 0.002). Mitral valve lesions were predominant, especially mitral stenosis (46.2%) and regurgitation (40.0%). Most patients (45.6%) had preserved left ventricular ejection fraction, rate-control strategy was preferred (63.2%), and 88.2% had CHA₂DS₂-VASc ≥2, indicating high thromboembolic risk. Conclusion: AF in this cohort primarily affected elderly individuals with major cardiovascular comorbidities and high stroke risk. The persistence of rheumatic etiology in valvular AF underscores the need for continued preventive programs. Early detection, comorbidity control, and optimized anticoagulation remain crucial to improve outcomes in Indian AF patients.