What is the clinical evidence from this study?

Study design: Review. Population: Atrial fibrillation. Intervention: Management of Atrial Fibrillation.

What question did this study set out to answer?

This paper examines the management of atrial fibrillation in older adults, focusing on treatment complications and outcomes.

May 15, 2026Journal of the American College of Cardiology

Management of Atrial Fibrillation in Patients 75 Years and Older

View Full Paper

Ask AI

Bookmark

Key result

DOACs improve stroke prevention over warfarin in older adults with AF.

Why the study?

The prevalence of AF and treatment-related complications increase in older adults, yet patients aged 75 years and older have generally been under-represented in clinical trials.

Population

Patients with AF aged 75 years and older

Design

Review

Authors

AVAnnabelle Santos VolgmanElectrophysiology GNGatha NairRush University Medical Center RLRadmila LyubarovaCardiac Imaging

Discussion

Member takes

Implication

May support digoxin for rate control in older AF patients to reduce falls; leaves open whether it improves cost-effectiveness versus alternatives.

Key Points

This paper examines the management of atrial fibrillation in older adults, focusing on treatment complications and outcomes.
Review of AF treatment approaches for patients aged 75 and older.
Analysis of complications associated with oral anticoagulation and antiarrhythmic drugs.
Recommendations for invasive procedures in selected patients.
Increased risk of stroke and bleeding in older adults necessitates careful management of anticoagulation (OAC use).
Digoxin is limited due to associations with higher mortality rates.
Direct OACs show benefits over warfarin for stroke prevention in the elderly.

Structured PICO

Population

Older adults (≥75 years of age) with atrial fibrillation

Intervention

Management strategies including oral anticoagulation (OAC), direct OACs, rate/rhythm control, digoxin, catheter ablation, pacemaker implantation/atrioventricular junction ablation, and left atrial appendage occlusion

Direct OACs and appropriately selected invasive procedures are beneficial for managing AF in adults ≥75 years, despite higher complication risks and under-representation in clinical trials.

Limitations

Older adults have generally been under-represented in clinical trials.
older adults have generally been under-represented in clinical trials

Cite This Study

Volgman et al. (2022) conducted a review in Atrial fibrillation. Management of Atrial Fibrillation was evaluated. Direct oral anticoagulants provide benefits compared with warfarin for stroke prophylaxis in older adults with atrial fibrillation, despite their general under-representation in clinical trials.

synapsesocial.com/papers/6a06e509a006b3155ce94fa4 https://doi.org/10.1016/j.jacc.2021.10.037

Topics

Atrial fibrillation Persistent AF management Left atrial appendage closure Anticoagulation in AF AF ablation outcomes

View Full Paper

Ask AI

Bookmark

Implication

May support digoxin for rate control in older AF patients to reduce falls; leaves open whether it improves cost-effectiveness versus alternatives.

Management of Atrial Fibrillation in Patients 75 Years and Older

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Management of Atrial Fibrillation in Patients 75 Years and Older

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider