Archives of the
Turkish Society of Cardiology
Invited review - General

Atrial fibrillation in the elderly


İstanbul Üniversitesi İstanbul Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul

Archives of the Turkish Society of Cardiology 2017; 45: Supplement 75-82
DOI: 10.5543/tkda.2017.37863
Read: 774 Downloads: 265 Published: 01 July 2021

The prevalence of atrial fibrillation increases dramatically with advancing age. Elderly adults with atrial fibrillation -even those with high bleeding risk- benefit from anticoagulation. The risk of ischemic stroke or systemic embolism was significantly lower with new direct oral anticoagulants (DOACs) than warfarin as was the risk of major bleeding and intracranial bleeding. Antiplatelet therapy should have a limited role for stroke prevention in elderly adults. Left atrial appendix occlusion may be a suitable alternative for those with contraindications to oral anticoagulants. For symptom management, it is likely that a strategy of lenient rate control is reasonable in elderly adults with atrial fibrillation. Rhythm control should be reserved for specific circumstances, in particular when symptoms cannot be managed using rate control. In appropriately selected elderly adults with symptomatic atrial fibrillation, catheter ablation may also be a useful strategy, with acceptable safety and efficacy based on limited data. A rhythm control strategy should not preclude anticoagulation.

ISSN 1016-5169 EISSN 1308-4488