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Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age

Atrial fibrillation (AF) is the commonest of all sustained arrhythmias, and most of the patients seeking medical therapy are in the elderly age group. The management of these patients is particularly difficult due to associated comorbidities. Hypertension, congestive heart failure, left ventricular...

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Autores principales: Haegeli, Laurent M., Duru, Firat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE-Hindawi Access to Research 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157010/
https://www.ncbi.nlm.nih.gov/pubmed/21860800
http://dx.doi.org/10.4061/2011/854205
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author Haegeli, Laurent M.
Duru, Firat
author_facet Haegeli, Laurent M.
Duru, Firat
author_sort Haegeli, Laurent M.
collection PubMed
description Atrial fibrillation (AF) is the commonest of all sustained arrhythmias, and most of the patients seeking medical therapy are in the elderly age group. The management of these patients is particularly difficult due to associated comorbidities. Hypertension, congestive heart failure, left ventricular hypertrophy, and coronary artery disease are often present in the elderly patient population, and therefore, antiarrhythmic drugs often fail due to side effects, proarrhythmia, or poor rhythm control. Recently, radiofrequency catheter ablation has been widely performed as an efficient therapy for recurrent, drug-refractory AF. Nevertheless, patients at old age were underrepresented in prior AF ablation trials, and the current guidelines for catheter ablation of AF recommend a noninvasive approach in the elderly patient group due to the lack of clinical data supporting ablation therapy. However, study results of our group and others are suggesting that catheter ablation is a safe and effective treatment for patients over the age of 65 years with symptomatic, drug-refractory AF, and therefore, patients should not be precluded from catheter ablation only on the basis of age. This paper discusses the pharmacological (rhythm control, rate control, and anticoagulation) and catheter management of AF in the elderly population.
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spelling pubmed-31570102011-08-22 Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age Haegeli, Laurent M. Duru, Firat Cardiol Res Pract Review Article Atrial fibrillation (AF) is the commonest of all sustained arrhythmias, and most of the patients seeking medical therapy are in the elderly age group. The management of these patients is particularly difficult due to associated comorbidities. Hypertension, congestive heart failure, left ventricular hypertrophy, and coronary artery disease are often present in the elderly patient population, and therefore, antiarrhythmic drugs often fail due to side effects, proarrhythmia, or poor rhythm control. Recently, radiofrequency catheter ablation has been widely performed as an efficient therapy for recurrent, drug-refractory AF. Nevertheless, patients at old age were underrepresented in prior AF ablation trials, and the current guidelines for catheter ablation of AF recommend a noninvasive approach in the elderly patient group due to the lack of clinical data supporting ablation therapy. However, study results of our group and others are suggesting that catheter ablation is a safe and effective treatment for patients over the age of 65 years with symptomatic, drug-refractory AF, and therefore, patients should not be precluded from catheter ablation only on the basis of age. This paper discusses the pharmacological (rhythm control, rate control, and anticoagulation) and catheter management of AF in the elderly population. SAGE-Hindawi Access to Research 2011 2011-08-11 /pmc/articles/PMC3157010/ /pubmed/21860800 http://dx.doi.org/10.4061/2011/854205 Text en Copyright © 2011 L. M. Haegeli and F. Duru. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Haegeli, Laurent M.
Duru, Firat
Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age
title Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age
title_full Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age
title_fullStr Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age
title_full_unstemmed Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age
title_short Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age
title_sort management of patients with atrial fibrillation: specific considerations for the old age
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157010/
https://www.ncbi.nlm.nih.gov/pubmed/21860800
http://dx.doi.org/10.4061/2011/854205
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