Epidemiological characteristics, management, and outcomes of atrial fibrillation in TUNISIA: Results from the National Tunisian Registry of Atrial Fibrillation (NATURE‐AF)
Authors: Ouali Sana , Ben Halima Afef , Chabrak Sonia , Chettaoui Rafik , Ben Halima Manel , Haggui Abdeddayem , Krichane Salma , Noureddine Larbi , Marrakchi Sonia , Charfeddine Selma , Hassine Majed , Sayahi Khaled , Abbes Mohamed Fehmi , Nasraoui Wided , Ajmi Hassen , Ben Miled Mehdi , Jebbari Zeynab , Meghaieth Mohamed Ali , Allouche Emna , Mechmeche Rachid , Zakhama Lilia , Sdiri Wissem , Ben Khalfallah Ali , Gharbi Anissa , Milouchi Sami , Neji Ali , Antit Saoussen , Battikh Kais , Drissa Meriem , Kaabachi Samira , Najar Tarek , Tlili Rami , Chahbani Iheb , Charfeddine Hanene , Ben Mbarek Mohamed , Braham Sami , Maatouk Faouzi , Abdesselem Salem , Ayari Mokdad , Garbaa Riadh , Hamrouni Nabil , Mbarek Dorra , Rekik Hajer , Zaghdoudi Hamda , Ayadi Wacef , Baraket Feriel , Ben Brahim Karim , Ben Romdhane Mariem , Bousadia Habib , Brahim Wassim , Mezri Malek , Guesmi Ali , Ounissi Taha , Kammoun Sofiene , Smati Wajih , Tlili Samir , Zoughi Karim , Zemni Jawher , Cheikh Bouhlel Mahmoud , Islem Sanaa , Jemli Rym , Joulak Anissa , Mzoughi Khadija , Naanea Hela , Hached Leila , Hadrich Moufid , Hmem Mohamed , Kacem Slim , Kammoun Ikram , Othmani Rawdha , Ouerghi Amel , Abid Syrine , Ennouri Ridha , Haidar Sandrine , Heraiech Sihem , Jammali Monia , Jarrar Mourad , Riahi Leila , Trimech Basma , Azaiez Med Ali , Azzouzi Foued , Ben Jemaa Khaled , Ben Rejab Oussema , Chrigui Rim , Wechtati Wejdene , Boughzela Essia , Jridi Gouider , Bezdah Leila , Kraiem Sondes , Drissa Habiba , Ben Youssef Soraya , Fehri Wafa , Kachboura Salem , Gamra Habib , Kammoun Samir , Mourali Mohamed Sami , Addad Faouzi , Abid Leila 
Published: March 2021

Background

Contemporary registries on atrial fibrillation (AF) are scare in North African countries.

Hypothesis

In the context of the epidemiological transition, prevalence of valvular AF in Tunisia has decreased and the quality of management is still suboptimal.

Methods

NATURE‐AF is a prospective Tunisian registry, involving consecutive patients with AF from March 1, 2017 to May 31, 2017, with a one‐year follow‐up period. All the patients with an Electrocardiogram‐documented AF, confirmed in the year prior to enrolment were eligible. The epidemiological characteristics and outcomes were described.

Results

A total of 915 patients were included in this study, with a mean age of 64.3 ± 22 years and a male/female sex ratio of 0.93. Valvular AF was identified in 22.4% of the patients. The mean CHA2DS2VASC score in nonvalvular AF was 2.4 ± 1.6. Monotherapy with antiplatelet agents was prescribed for 13.8% of the patients. However, 21.7% of the subjects did not receive any antithrombotic agent. Oral anticoagulants were prescribed for half of the patients with a low embolic risk score. In 341 patients, the mean time in therapeutic range was 48.87 ± 28.69%. Amiodarone was the most common antiarrhythmic agent used (52.6%). During a 12‐month follow‐up period, 15 patients (1.64%) had thromboembolism, 53 patients (5.8%) had major hemorrhage, and 52 patients (5.7%) died.

Conclusions

NATURE‐AF has provided systematic collection of contemporary data regarding the epidemiological and clinical characteristics as well as the management of AF by cardiologists in Tunisia. Valvular AF is still prevalent and the quality of anticoagulation was suboptimal.