The Correlates of Atrial Fibrillation in a Random Sample of Congolese Inhabitants of the City of Kinshasa, the Democratic Republic of the Congo

Abstract

Objective: To assess the prevalence of atrial fibrillation (AF) and its associated cardiovascular risk factors in the city of Kinshasa, DR Congo. Methods: From August to September 2022, 2641 inhabitants of Kinshasa aged ≥45years were visited at home by trained observers who collected information on lifestyle habits, use of modern or traditional medicine for chronic diseases and measured body weight, height, blood pressure and heart rate. They used Alivecor Kardia Cardia device to screen for AF and a 12lead ECG for confirmation. The likelihood of AF was modelized in a multivariable logistic regression analysis. Results: Suspected in 118 participants (4.6%), AF was confirmed in 108 subjects (4.2%) arguing for intrinsic validity of the Alivecor Kardia Cardia with 100% NPV and sensitivity, and 99.6% specificity compared to standard 12 lead-ECG. AF prevalence was higher (p=0,018) in men (5.2%) than women (3.4%), in participants with higher monthly income (p<0.001) and increased with age (p<0.001). Hypertension (58,2vs39.4%), dyslipidaemia (22.2vs2.9%), heart failure (36.1vs1.9%), stroke (13vs3.3 %), previous myocardial infarction (2.8vs0.6%) and heart palpitations (64.8vs36.3%) predominated whilst diabetes mellitus (11.1vs18.9%) and tobacco consumption (4.6vs9.8%) were less frequent among participants with AF. In multivariable adjusted logistic analysis, the odds (95% CI) for AF were 5,5 (2,25) for heart failure, 4.6(2,67-11,33) for overweight/obesity, 2.1(1,04-4,19) for hypertension and 3.4(1,73-6,89) for age ≥70 years. Conclusion: AF affects a sizable proportion of adult Congolese people with heart failure, palpitations, hypertension, and overweight/obesity as significant correlates. The association with heart failure holds in a dual register with AF as either a culprit or a consequence.