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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Lone atrial fibrillation in elderly persons: a marker for cardiovascular risk

S L Kopecky1, B J Gersh, M D McGoon

  • 1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.

Archives of Internal Medicine
|May 21, 1999
PubMed

Insights

Lone atrial fibrillation after age 60 significantly increases cardiovascular event risk compared to the general population. This finding suggests antithrombotic therapy may be warranted for older individuals with LAF.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Epidemiology

Background:

  • Lone atrial fibrillation (LAF) in individuals under 60 does not elevate stroke risk above general population levels.
  • The cardiovascular risk associated with LAF in individuals over 60 remains less understood.

Purpose of the Study:

  • To investigate the risk of stroke and other cardiovascular events in older adults (aged 60+) diagnosed with lone atrial fibrillation.
  • To compare cardiovascular event rates in older LAF patients with an age- and sex-matched control group.

Main Methods:

  • A population-based study was conducted at a single institution.
  • 55 patients with LAF (mean age 74) and without significant comorbidities were compared to age- and sex-matched controls.
  • Follow-up averaged 9.6 years, monitoring for cardiovascular events including stroke, transient ischemic attacks, and myocardial infarction.

Main Results:

  • Patients with LAF experienced significantly higher rates of total cardiovascular events (5.0% per person-year) compared to controls (1.3% per person-year).
  • Specific event rates for LAF patients included 0.9% for stroke, 1.1% for transient cerebral ischemia, and 2.6% for myocardial infarction.
  • While cardiovascular event incidence was higher, survival rates did not differ between the LAF and control groups.

Conclusions:

  • Lone atrial fibrillation diagnosed after age 60 serves as a significant risk marker for increased cardiovascular events.
  • These findings support the consideration of antithrombotic therapy for older individuals diagnosed with LAF to mitigate cardiovascular risk.
Abstract

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