oa Does religious fasting in the Islamic holy month of Ramadan predispose to atrial fibrillation? A population-based study

Background and Objectives: Over one billion Muslims religiously fast worldwide during the month of Ramadan. Fasting during Ramadan is essentially a radical change in lifestyle for the period of one lunar month, so it is important to see whether this change predisposes patients to developing atrial fibrillation (AF). Our objective in this study is to investigate whether Ramadan fasting has any effect on the number of hospitalizations with AF in a geographically defined Islamic population. Methods: We conducted a retrospective review of clinical data study on all Qatari patients in Qatar for a period of 20 years (January 1991 through December 2010) who were hospitalized with AF. Patients were divided according to the time of presentation in relation to the month of Ramadan; 1 month before, during and 1 month after Ramadan. The number of hospitalizations for AF in various time periods was analyzed. The age of presentation, gender, cardiovascular risk factor profiles and outcome were analyzed. Results: Of the 41,453 patients treated during the 20-year period, 14,814 of them were Qataris, 8758 being males and 6056 females. Overall, 1718 Qatari patients were hospitalized for AF and their mean age and standard deviation was 61±16 years, 47.3% were hypertensive, 7.5% were current smokers and 39.2% were diabetics. The overall mortality was 5.9%. The number of hospitalizations for AF was not significantly different in Ramadan (143 cases) when compared to a month before Ramadan (136 cases) and a month after Ramadan (151 cases); p = 0.95. There was no significant difference found in the baseline clinical characteristics, presentation, or mortality in patients presenting in various time periods (p = non-significant for all) [Table]. Conclusions: This population-based study demonstrates for the first time no significant difference in the number of hospitalizations for AF and related morbidity and mortality while fasting in Ramadan when compared to the non-fasting months. We therefore conclude that religious Ramadan fasting does not predispose to the development of AF.