Frequency of Atrial Fibrillation in Patients With Dilated Cardiomyopathy at a Tertiary Care Hospital, Peshawar

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in patients with dilated cardiomyopathy (DCM) and is associated with worsening heart failure, thromboembolic events, and increased mortality. This study aimed to determine the frequency of AF and evaluate its association with demographic and echocardiographic characteristics in patients with DCM. Methods: This cross-sectional study was conducted in the Department of Cardiology, Lady Reading Hospital, Peshawar, from February to June 2026. A total of 113 patients with echocardiographically confirmed DCM were enrolled using a non-probability convenience sampling technique. Demographic and clinical data were collected using a structured questionnaire. Atrial fibrillation was diagnosed using a standard 12-lead electrocardiogram (ECG). Data was analyzed using R software (version 4.3), and a p-value <0.05 was considered statistically significant. Results: Among the 113 patients, 20 (17.7%) had AF, while 93 (82.3%) were in sinus rhythm. The mean age of the participants was 55.9 ± 9.2 years, and 78 (69.0%) were male. No significant association was observed between AF and age (p = 0.20) or gender (p = 0.13). However, AF was significantly associated with the severity of mitral regurgitation (p = 0.011). Patients with AF also demonstrated a higher prevalence of severe left ventricular systolic dysfunction, with borderline statistical significance for left ventricular ejection fraction <30% (p = 0.074). Conclusion: Atrial fibrillation was present in nearly one-fifth of patients with DCM and was significantly associated with mitral regurgitation and severe left ventricular systolic dysfunction. Early recognition of AF and echocardiographic abnormalities may improve risk stratification and clinical management in patients with DCM.