Managing atrial fibrillation in the very elderly patient: challenges and solutions

Vasc Health Risk Manag. 2015 Oct 27;11:555-62. doi: 10.2147/VHRM.S83664. eCollection 2015.

Abstract

Atrial fibrillation (AF) is the most common arrhythmia affecting elderly patients. Management and treatment of AF in this rapidly growing population of older patients involve a comprehensive assessment that includes comorbidities, functional, and social status. The cornerstone in therapy of AF is thromboembolic protection. Anticoagulation therapy has evolved, using conventional or newer medications. Percutaneous left atrial appendage closure is a new invasive procedure evolving as an alternative to systematic anticoagulation therapy. Rate or rhythm control leads to relief in symptoms, fewer hospitalizations, and an improvement in quality of life. Invasive methods, such as catheter ablation, are the new frontier of treatment in maintaining an even sinus rhythm in this particular population.

Keywords: anticoagulation; atrial fibrillation; catheter ablation; drugs; elderly.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anti-Arrhythmia Agents / adverse effects
  • Anti-Arrhythmia Agents / therapeutic use*
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Atrial Appendage / physiopathology*
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy*
  • Cardiac Catheterization* / adverse effects
  • Catheter Ablation* / adverse effects
  • Comorbidity
  • Female
  • Heart Rate
  • Humans
  • Male
  • Prevalence
  • Quality of Life
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents
  • Anticoagulants