Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia with an increasing incidence and prevalence in older age groups compared to younger individuals and the general population. Younger patients with AF often have different clinical characteristics, risk factors, and outcomes. Because AF among the young has not been studied in Middle Eastern populations, we conducted this study to provide valuable insights into the differences in the baseline clinical characteristics and the one-year adverse events between young and older AF patients, and thus contribute to formulate future treatment strategies and improve health outcomes. Methods: Consecutive adult patients previously or newly diagnosed with AF in 30 hospitals and out-patient cardiology clinics were enrolled in the Jordan AF study from May 2019 to October 2020. All patients were followed-up for one year. Baseline clinical characteristics and the one-year adverse events were assessed in young (<50 years) and older (≥ 50 years) adult patients with AF. Results: Of the 2020 AF patients enrolled in the study, 201 (10%) were young. Young patients were more likely to be men (75.6% vs. 43.8%, p<0.001), and had a lower prevalence of hypertension (31.3% vs. 79.3%, p<0.001), diabetes mellitus (10.4% vs. 47.2%, p<0.001), and previous stroke (9.0% vs. 16.1%, p=0.027) compared to older patients. Furthermore, young patients had a lower mean CHA 2DS 2-VASc score (1.1±1.4 vs. 3.9±1.7, p<0.001) and mean HAS-BLED score (0.6±0.7 vs. 1.8±1.1, p<0.001). The use of oral anticoagulant agents was significantly lower in young patients (39.3% vs. 75.0%, p<0.001). Young patients also had lower one-year all-cause mortality (1.1% vs. 13.7%, p=0.001), cardiovascular mortality (1.1% vs. 7.7%, p=0.04) and major bleeding (0% vs. 2.7%, p=0.021) compared to older patients. The rate of stroke and systemic embolization was similar in both groups (3.4% vs. 4.4%) Conclusion: The findings of the Jordan AF study suggest that young patients (<50 years of age) comprise a small proportion (10%) of the overall AF patient population. They had more favorable baseline clinical characteristics and risk scores compared to older patients. The one-year mortality and major bleeding rates in young patients were also lower than that in older patients.

Background: Following the remarkable spread of coronavirus disease 2019 (COVID-19), worldwide, it quickly became apparent that many public health systems worldwide were not prepared to manage such a pandemic. We aimed to assess the perceptions of primary care physicians (PCPs) in Jordan toward their role during COVID-19. Methods: A cross-sectional study using a self-administered questionnaire was performed. The study participants included PCPs from the Ministry of Health, academic institutions, and the private sector in Jordan. Results: A total of 221 PCPs participated in the study. Most participants reported not having received any training on infection control (59.7%) or COVID-19 (81%). More than half PCPs (53.4%) felt positive about the way patients received and/or complied with their instructions. More than half PCPs (55.7%) educated their patients on protective measures against COVID-19 infection and considered this as part of their role and responsibility. Over 80% of the participants would apply social distancing, hand sanitation, facial masks, and patient education, but only half (51.1%) reported planning to order COVID-19 test kits. Conclusions: PCPs had a positive attitude toward controlling COVID-19 infection and showed a willingness to educate patients on how to protect themselves. However, PCPs should be provided special training on COVID-19.