Clinical Characteristics and Short-Term Outcomes of Patients With Atrial Fibrillation at Three Rwandan Referral Hospitals, Kigali

Background The coexistence of lifestyle related non-communicable diseases and chronic rheumatic heart disease in Sub-Saharan Africa makes atrial fibrillation a more prevalent disease with substantial morbidity and mortality due to suboptimal management. Little is known about its clinical features and its outcomes in Rwanda. Objectives This study was designed to determine the clinical characteristics of patients with atrial fibrillation and to assess its 12-month mortality, stroke and hospitalization rates at Rwandan referral hospitals. Methods A prospective cohort study was conducted between September 2023 and February 2025 at three referral hospital in Kigali, Rwanda. Patients' clinical presentation, risk factors and management strategy were analyzed and each participant was followed for a period of 12 months for event rates. Results One hundred and forty-eight patients were recruited (mean age 63 ± 17 years, females 69.5%). Hypertension (44.5%), chronic rheumatic heart disease (33.78%) and Cardiomyopathies (28.3%) were the main associated comorbidities. Rate control was the preferred management strategy (73.9%), primarily using beta-blockers. Rhythm-control was rarely used (4%). Out of 140 high-risk patients, 85% received anticoagulation—mainly warfarin for valvular atrial fibrillation and rivaroxaban for non-valvular atrial fibrillation. After 12 months of follow-up, 13.9% died, 6.2% had ischemic stroke and 30% were hospitalized. Conclusion The findings suggest that the Rwandan population develops atrial fibrillation at a relatively young age with female predominance. Hypertension and chronic rheumatic heart disease are the leading co-morbidities and atrial fibrillation carries high morbidity and mortality in our population.