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Atrial fibrillation screening in Syrian patients reporting to the emergency department during the ongoing conflict: a cross-sectional study

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posted on 2025-09-16, 15:18 authored by Ibrahim Antoun, Alkassem Alkhayer, Aref Jalal Eldin, Alamer Alkhayer, Ibrahim Salama, Khaled Yazji, Riyaz Somani, Ghulam NgGhulam Ng, Mustafa ZakkarMustafa Zakkar
BackgroundAtrial fibrillation (AF) is the most common arrhythmia worldwide. Data regarding AF screening in conflict countries’ emergency departments (ED) is lacking.MethodsWe included consecutive patients >40 years old who reported to the ED of a Syrian tertiary centre between July 2024 and September 2024. Patients had routine 12-lead electrocardiograms (ECGs) regardless of presenting complaints. Two cardiology consultants blindly verified ECG findings. We excluded critically unwell patients and ECG discrepancies between the two consultants. Data were taken from patients’ medical notes.ResultsThe final analysis included 694 patients, 101 (15%) had AF on the ECG. The most common presenting complaints and ECG abnormality were trauma (44%) and sinus tachycardia (15%), respectively. Compared to the rest of the patients, AF patients were older (66 vs. 59 years; p < 0.001), had a lower proportion of males (39% vs. 54%; p = 0.01), a higher prevalence of diabetes mellitus (49% vs. 21%; p = 0.01), and more cases of congestive cardiac failure (CCF) (38% vs. 17%; p < 0.001). AF patients also had a higher CHA₂DS₂-VASc score (3 vs. 2; p < 0.001). CCF [odds ratio [OR]: 3.3, 95% confidence interval [CI]: 1.5–6.4, p < 0.001] and a higher CHA₂DS₂-VASc score(OR: 4, 95% CI: 1.6–7.7, p < 0.001) were independently associated with positive AF screening.Conclusion15% of patients reporting to this Syrian ED had positive AF screening. CCF and CHA₂DS₂-VASc scores are predictive of AF.<p></p>

Funding

British Heart Foundation Research Excellence Award (RE/24/130031)

Neurocardiac interaction in malignant ventricular arrhythmias and sudden cardiac death

British Heart Foundation

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Development of a successful novel technology for sudden cardiac death risk stratification for clinical use - LifeMap

Medical Research Council

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LifeMap Quality-assurance User-focussed Evaluation of Safety and Tolerability (LifeMap-QUEST) : developing LifeMap-Vest and LifeMap-Compute for exercise assessment with optimised digital ECG recording for sudden death risk stratification

National Institute for Health Research

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The BHF Chair of Cardiac Surgery

British Heart Foundation

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NIHR Leicester Biomedical Research Centre

National Institute for Health Research

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History

Author affiliation

College of Life Sciences Medical Sciences

Version

  • VoR (Version of Record)

Published in

Frontiers in Cardiovascular Medicine

Volume

12

Pagination

1512558

Publisher

Frontiers Media SA

issn

2297-055X

eissn

2297-055X

Copyright date

2025

Available date

2025-09-16

Spatial coverage

Switzerland

Language

eng

Deposited by

Dr Ibrahim Antoun

Deposit date

2025-08-29

Data Access Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

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