Why the study?
Does rhythm-control compared to rate-control improve outcomes in elderly patients with atrial fibrillation?
Does rhythm-control compared to rate-control improve outcomes in elderly patients with atrial fibrillation?
This review highlights that rate and rhythm control strategies lack clear superiority in elderly AF patients, emphasizing the need for individualized treatment considering age-related comorbidities and proarrhythmic risks.
Individualized AF strategies remain prudent in elderly patients; leaves open optimal rate versus rhythm selection for dedicated trials.
Atrial fibrillation (AF) is a relevant cardiovascular condition that is more prevalent in the elderly patients aged over 65 years. AF, with abnormal rate and rhythm can cause symptoms directly or indirectly by exacerbating other frequently coexisting cardiac conditions such as valvular heart disease, hypertension, ischemic cardiomyopathy, dilated cardiomyopathy, and hypertrophic cardiomyopathy. Evidence suggests that aging-related cardiovascular changes predispose to the elderly to AF. Current therapeutic options such as antiarrhythmic drugs have not been extensively evaluated in the elderly population. Emerging pharmacological and non-pharmacological treatment options for the management of AF, such as dronedarone or catheter ablation, are of particular interest in the elderly. The present paper reviews the pathophysiology, diagnosis, and the management of AF in the elderly patient.
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Botto et al. (2018) studied this question.
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