GUIDELINE RECOMMENDED PHARMACOLOGICAL MANAGEMENT OF PATIENTS WITH ATRIAL FIBRILLATION, AT A TERTIARY CARE CARDIAC CENTRE, KARACHI PAKISTAN" ARE WE PRACTICING WHAT WE TEACH"?

Objective: To observe the practice of guideline recommend, pharmacological management of patients with Atrial fibrillation (AF), at tertiary care cardiac center. Methodology: It was a descriptive cross-sectional study of six months duration conducted in National Institute of Cardiovascular Diseases Karachi (NICVD) from April to October 2007. Two hundred indoor patients with AF were evaluated. Data was recorded and analyzed by SPSS version 16. Results: Majority of the patients with AF (76%), were <65 years of age. 46.5 % of patients had valvular heart disease. Rate controlling drugs were prescribed in 180 (90%) patients. Total of 88 (44%) patients received beta blocker, 83 (41.5%) patients received digoxin. In 19% of the patients with high risk for thromboemoblism, neither Aspirin nor Warfarin was prescribed. In 14 % of low risk patients, both Aspirin and Warfarin were advised. Conclusion: In contrast to western studies majority of our patients with AF were younger and almost half of them had valvular heart disease. Reasonable number of our patients with AF received guideline recommended pharmacological rate controlling therapy. Preventive pharmacological strategy for thromboembolic events was highly un-acceptable.