The purpose of this retrospective study covering a 10-year period was to analyze epidemiological data and associated conditions related to atrial fibrillation (AF) in a cardiology hospital setting in SubSaharan Africa. METHODS A total of 217 charts of patients hospitalized in the Medical Department of the Abidjan Cardiology Institute between August 1995 and August 2005 were reviewed. RESULTS During the study, a total of 3,908 patients were admitted to the department, including 217 for AF for a hospital prevalence of 5.5%. There were 113 men (52%) and 104 women (48%) for a sex ratio of 1.08. Overall mean patient age was 58.9 years (range, 18 to 91 years). The difference in the mean age of men and women was not statistically significant: 57.8 versus 60 years respectively. The main symptoms at the time of admission to the hospital were exertional dyspnea (55.7%) and palpitations (22.1%). A total of 136 patients (62.6%) exhibited cardiac insufficiency. Heart disease was diagnosed in 192 patients including hypertensive cardiopathy in 48% and rheumatic valvular heart disease in 28%. The thromboembolic risk was moderate in 47% of patients (CHADS2 score, between 1 and 2) and high in 18.4% (CHADS2 score > or = 3). CONCLUSIONS In our practice, hypertensive and rheumatic valvular heart disease were the main causes of AF that was associated with an alarming thromboembolic risk. These findings indicate that further effort is needed to prevent arterial hypertension and acute rheumatic joint disease.