Atrial fibrillation among adults hospitalized with heart failure in Southern Ethiopia: prevalence, predictors, and embolic complications

To determine the prevalence, clinical predictors, and embolic complications of atrial fibrillation among adults hospitalized with heart failure in Southern Ethiopia. Among 403 adults hospitalized with heart failure (mean age 53.3 ± 18.1 years; 60.5% women), atrial fibrillation was present in 30.5% (95% CI: 26–35%). The most common underlying etiologies were valvular heart disease and dilated cardiomyopathy. Embolic complications occurred in 8.9% of patients, predominantly ischemic stroke; some events were present at admission, limiting causal inference. Independent predictors of atrial fibrillation included age > 60 years, diabetes mellitus, chronic kidney disease, and left atrial enlargement (> 40 mm), whereas hypertension showed an inverse association. Atrial fibrillation was significantly associated with embolic complications. Among patients receiving warfarin, only 31.9% achieved therapeutic anticoagulation, and subtherapeutic anticoagulation was associated with increased embolic risk.