Investigation of atrial fibrillation frequency in relation to possible thromboembolic events in geriatric patients attending family medicine outpatient clinics

Objective: Atrial fibrillation (AF) is the most common type of arrhythmia and is responsible for a large proportion of hospitalizations. In this study, we aimed to investigate the presence of atrial fibrillation(AF) without developing thromboembolic complications in patients who applied to family medicine. Methods: The study included patients over 65 who applied to A University Training and Research Hospital and a State Hospital Family Medicine polyclinic. Those who had previously been diagnosed with AF were excluded from the study. Electrocardiography (ECG) was performed on patients over 65 who applied to our polyclinics to examine the frequency of AF. To assess the risk of thromboembolism, the CHA2DS2-VASc score was utilized. This score is a widely accepted and validated risk stratification system designed to predict stroke in patients with non-valvular AF. Results: In a study involving 146 participants with a mean age of 73.86±7.38 years (61.6% female, 38.4% male), AF incidence was 11%. Isolated hypertension was the most common diagnosis, affecting 58% of patients with chronic diseases linked to AF. While AF was more prevalent in men (14.3%), the difference was insignificant (p=0.310). Most patients with AF (87.5%) had a CHA2DS2-VASc score of 2 or higher. The mean systolic blood pressure was 132.59±22.03 mmHg in non-AF patients compared to 124.00±21.62 mmHg in AF patients. A history of cardiac surgery and arrhythmias was associated with a higher incidence of AF (p=0.010). Conclusion: The prevalence of AF in individuals over 65 years of age was found to be 11%, and the presence of comorbid disease was found to constitute the most important risk group. CHA2DS2-VASc score was two or above in 87.5% of patients and formed the high-risk group for stroke. In the study, patients with AF diagnosed before the development of thromboembolic complications were referred to the cardiology clinic for thromboembolic prophylaxis. This allowed the organization of cost-effective treatments based on bleeding risk scores and clinical indications. In primary health care services, every patient presentation should be evaluated effectively, and patients with symptoms and findings from a physical examination should be examined for AF.