Management of Atrial Fibrillation in Elderly Adults

J Am Geriatr Soc. 2017 Jan;65(1):185-193. doi: 10.1111/jgs.14483. Epub 2016 Dec 2.

Abstract

Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms. The evidence to support novel AF treatment strategies in elderly adults is reviewed, including novel oral anticoagulants and left atrial appendage closure for stroke risk reduction and catheter ablation for control of symptoms.

Keywords: atrial fibrillation; elderly; stroke prevention.

Publication types

  • Review

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use
  • Atrial Appendage / surgery
  • Atrial Fibrillation / therapy*
  • Catheter Ablation
  • Cognitive Dysfunction / complications
  • Comorbidity
  • Electric Countershock
  • Hemorrhage / chemically induced
  • Humans
  • Platelet Aggregation Inhibitors / therapeutic use
  • Stroke / prevention & control
  • Thromboembolism / prevention & control

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors