Key result
Rhythm vs rate control in elderly AF lacks comparative data, requiring individualized management.
Why the study?
Atrial fibrillation is very common in the elderly and causes substantial symptoms, morbidity, thromboembolism, and stroke, yet no data establish whether rhythm control or rate control is the best therapeutic approach.
This review highlights that because comparative data between rhythm control and rate control are lacking for elderly patients with atrial fibrillation, therapy must be individualized.
Answers are grounded in this paper and cite their sources.
Supports individualized management in elderly AF patients; leaves open the optimal rhythm versus rate strategy pending dedicated trials.
Atrial fibrillation is the most common sustained arrhythmia seen in clinical practice. Although it occurs in any age patients, its frequency increases with age and is very common in the elderly. Atrial fibrillation causes substantial symptoms and morbidity and is an important cause of thromboembolism and stroke. The two approaches for therapy in those patients with intermittent or persistent atrial fibrillation are (1) maintenance of sinus rhythm with an antiarrhythmic drug or nonpharmacologic therapy, and (2) maintenance of atrial fibrillation with rate control. At the present time there are no data about the best approach and therapy must therefore be individualized.
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Philip J. Podrid (1999) conducted a review in Atrial fibrillation in the elderly. Maintenance of sinus rhythm with an antiarrhythmic drug or nonpharmacologic therapy vs. Maintenance of atrial fibrillation with rate control was evaluated. Maintenance of sinus rhythm vs rate control in elderly patients with atrial fibrillation currently lacks comparative data on the best approach, requiring individualized therapy.
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