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Atrial fibrillation and heart failure in the elderly

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Abstract

Atrial fibrillation (AF) is a common clinical problem in elderly patients and especially in those with heart failure (HF). It is a major risk factor for serious cardiovascular events, such as stroke, HF and premature death. Both the prevalence and incidence of AF increase with age and its prevalence in the United States are estimated at more than 2.2 million, with nearly 75% of patients aged >65 years. Aging-related atrial remodeling with fibrosis, dilation and mitochondrial DNA mutations predispose elderly patients to AF. Current management options for AF, including rate control and anticoagulation therapy, can be successfully applied to the elderly population. New antiarrhythmic and anticoagulation medications such as dronedarone and dabigatran, respectively, can impact the approach to therapy in the elderly. Non-pharmacological options such as catheter-based ablation have also gained prominence and have been incorporated into the guidelines for management of AF. However, more trials in the elderly and very elderly segments are needed to clarify the safety and long-term efficacy of the new treatment options.

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Acknowledgments

This work was supported in part by grant # IAP-99003 from the Canadian Institutes of Health Research, Ottawa, Ontario. We thank Catherine Jugdutt for assistance.

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  1. Department of Medicine, 2C2 Walter MacKenzie Health Sciences Centre, Division of Cardiology, University of Alberta and Hospital, Edmonton, AB, T6G 2R7, Canada

    Pedram Kazemian, Gavin Oudit & Bodh I. Jugdutt

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  1. Pedram Kazemian
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  2. Gavin Oudit
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  3. Bodh I. Jugdutt
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Correspondence to Bodh I. Jugdutt.

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Kazemian, P., Oudit, G. & Jugdutt, B.I. Atrial fibrillation and heart failure in the elderly. Heart Fail Rev 17, 597–613 (2012). https://doi.org/10.1007/s10741-011-9290-y

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