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Atrial fibrillation in the elderly.

Anil Yadav1, Melvin Scheinman

  • 1Department of Medicine, Division of Cardiology, Cardiac Electrophysiology Section, University of California at San Francisco, San Francisco, CA 94143, USA. yadav@medicine.ucsf.edu

The American Journal of Geriatric Cardiology
|December 28, 2002
PubMed
Summary

Atrial fibrillation treatment in the elderly focuses on drug therapy for rate control, stroke prevention via anticoagulation, and maintaining sinus rhythm. Pacemakers or AV node ablation are options if rate control fails.

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Area of Science:

  • Cardiology
  • Geriatric Medicine

Background:

  • Atrial fibrillation is the most common arrhythmia in the US, particularly affecting the elderly.
  • This condition presents as paroxysmal or chronic and is linked to palpitations, dyspnea, stroke, and mortality.

Purpose of the Study:

  • To outline the primary treatment strategies for atrial fibrillation in the elderly population.
  • To emphasize the goals of pharmacologic therapy in managing this arrhythmia.

Main Methods:

  • Review of current treatment guidelines and therapeutic approaches for atrial fibrillation in older adults.
  • Discussion of pharmacologic interventions, including rate control, anticoagulation, and rhythm control.

Main Results:

  • Drug therapy is the cornerstone for managing atrial fibrillation in the elderly.

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  • Key therapeutic goals include effective rate control, stroke risk reduction through anticoagulation, and sinus rhythm maintenance.
  • Catheter ablation of the AV node with pacemaker implantation is considered for refractory rate control issues.

    • Conclusions:

    • Pharmacologic management is essential for atrial fibrillation in the elderly, targeting rate control, thromboembolism prevention, and sinus rhythm.
    • Pulmonary vein catheter ablation for atrial fibrillation is investigational and recommended only for select symptomatic patients refractory to traditional treatments.