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Related Concept Videos

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

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Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
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Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
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Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Updated: Feb 21, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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[Atrial fibrillation in the elderly].

Kamil Adalet1

  • 1Department of Cardiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey. kadalet@gmail.com.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|October 5, 2017
PubMed
Summary

Elderly adults with atrial fibrillation benefit from anticoagulation, with direct oral anticoagulants (DOACs) showing lower risks than warfarin. Other strategies like left atrial appendix occlusion and catheter ablation are alternatives for specific cases.

Area of Science:

  • Cardiology
  • Geriatrics
  • Neurology

Background:

  • Atrial fibrillation prevalence increases with age.
  • Anticoagulation is beneficial for elderly patients, even those at high risk of bleeding.
  • Stroke prevention in this demographic is critical.

Purpose of the Study:

  • To review current evidence on stroke prevention and symptom management in elderly adults with atrial fibrillation.
  • To compare the efficacy and safety of different anticoagulation strategies.
  • To evaluate alternative therapies for patients with contraindications to oral anticoagulants.

Main Methods:

  • Literature review of studies on atrial fibrillation management in the elderly.
  • Comparative analysis of direct oral anticoagulants (DOACs) versus warfarin.

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  • Assessment of antiplatelet therapy, left atrial appendix occlusion, rate control, rhythm control, and catheter ablation.

    • Main Results:

    • Direct oral anticoagulants (DOACs) demonstrated lower risks of ischemic stroke, systemic embolism, major bleeding, and intracranial bleeding compared to warfarin.
    • Antiplatelet therapy has a limited role in stroke prevention for this population.
    • Lenient rate control is a reasonable strategy for symptom management, with rhythm control reserved for specific situations.
    • Left atrial appendix occlusion and catheter ablation are potential alternatives for select patients.

    Conclusions:

    • Anticoagulation is recommended for elderly patients with atrial fibrillation, with DOACs offering a favorable risk-benefit profile over warfarin.
    • Alternative strategies exist for patients unable to tolerate oral anticoagulants.
    • A comprehensive approach considering rate/rhythm control and interventional procedures is essential for managing atrial fibrillation in the elderly.