Key result
Hypertension accounts for ~40% of non-valvular AF in young adults, followed by LVSD.
Why the study?
The spectrum of non-valvular atrial fibrillation among young adults is less known, despite atrial fibrillation contributing substantially to patient morbidity and mortality.
Observational (n=117)
No
In young adults under 40 years of age, hypertension and left ventricular systolic dysfunction are the predominant aetiologies for non-valvular atrial fibrillation.
Answers are grounded in this paper and cite their sources.
May inform etiology-focused evaluation in young AF; leaves open prospective validation of targeted interventions.
BACKGROUND: The development of atrial fibrillation adds a lot to the morbidity and mortality of individual patients. The spectrum of non-valvular atrial fibrillation among young adults is less known. The present observational study aims to analyze the clinical-aetiological spectrum of non-valvular atrial fibrillation among young adults between 18 and 40 years of age. METHODS: A retrospective observational study was carried out to analyze the clinical-aetiological spectrum of non-valvular atrial fibrillation among young adults less than 40 years of age attending the cardiac outpatient department in a tertiary care hospital in Eastern India over a period of two years. Patients with any form of organic valvular heart disease and patients more than 40 years of age were excluded from the study. One hundred and seventeen patients under 40 years of age were analysed with respect to demographic, aetiological, and clinical profiles. RESULTS: Most common aetiologies behind non-valvular atrial fibrillation in young adults (<40 years) were hypertension (40%) and the presence of left ventricular systolic dysfunction (31%). Thyrotoxicosis, obesity, obstructive sleep apnoea, the presence of congenital heart disease, coronary artery disease, myopericarditis, chronic kidney disease, dyselectronemia, diabetes mellitus, and the presence of chronic obstructive pulmonary disease contributed towards the development of non-valvular atrial fibrillation in the young population in less proportion of cases. Most of the cases were symptomatic with palpitation, shortness of breath, or diaphoresis. Less number of cases (17%) had left atrial thrombus which may be due to early clinical attention with the proper therapeutic anticoagulation regimen. CONCLUSIONS: Hypertension and the presence of left ventricular systolic dysfunction contribute to the majority towards the development of non-valvular atrial fibrillation among young adults. Accurate measurement and monitoring of blood pressure among young adults and careful assessment of left ventricular systolic dysfunction with subsequent appropriate management of hypertension and left ventricular systolic dysfunction in young can decrease the burden of non-valvular atrial fibrillation among the young population.
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Mohanty et al. (2023) conducted an observational in Non-valvular atrial fibrillation (n=117). Hypertension (40%) and left ventricular systolic dysfunction (31%) were the most common aetiologies of non-valvular atrial fibrillation in young adults under 40 years of age.
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