A prospective study on optimizing arrhythmia management in a tertiary care hospital

Background: Arrhythmias, particularly atrial fibrillation (AF), significantly contribute to morbidity and mortality, especially in older adults. Effective management is essential to reducing stroke risk and improving outcomes. However, real-world treatment often deviates from guidelines, raising concerns about care consistency. This study aims to identify prevalent arrhythmias, assess stroke risk, examine the relationship between arrhythmias and age, and analyze prescription patterns of antiarrhythmic drugs (AADs) and anticoagulants in a tertiary care setting. Methods: A prospective observational study was conducted with 50 patients diagnosed with arrhythmias. Data were collected through structured interviews using the arrhythmia-specific questionnaire in tachycardia and arrhythmia (ASTA) and medical records. Prescription patterns were analyzed using the Vaughan-Williams classification system. Results: Atrial fibrillation with a rapid ventricular rate (AF with FVR) was the most common arrhythmia (44%). A significant 88% of patients had a severe stroke risk based on the CHAD₂ scale. Beta-blockers were the most prescribed AADs (45.59%), with amiodarone being the most common (30.88%). Heparin (37.68%) and aspirin (28.99%) were the leading anticoagulants. Conclusions: The findings highlight AF’s high prevalence and associated stroke risk in older adults. While prescription patterns align with guidelines, the reliance on Amiodarone necessitates careful monitoring. Greater adherence to guideline-recommended newer oral anticoagulants (NOACs) is needed to optimize outcomes.