, Volume 19, Issue 10, pp 403-404
Date: 09 Sep 2011

Treatment of atrial fibrillation in the elderly: time for a change?

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Atrial fibrillation (AF) is the most common arrhythmia. The prevalence of AF is highly age dependent as the median age of AF patients is 75 years and at least 70% of AF patients are between 65 and 85 years old [1, 2]. With increasing life expectancy, AF prevalence will increase 2.5 times during the next 40 years and constitute an even more important health concern [1].

Symptoms may change as AF progresses from paroxysmal to permanent, especially in the elderly. Palpitations are more common among patients <65 years compared with patients aged 65–80 years (61% and 46%, respectively). However, other symptoms, such as dyspnoea and fatigue, are more prevailing in the elderly resulting in overall presence of symptoms in 75% among patients <65 years and 67% among patients between 65 and 80 years (Euro Heart Survey on AF, personal communications by HJGM Crijns). Care of AF patients poses a very high economic burden on society. The annual costs of the average AF patient are over 3000 euro (3600