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Special Problems in Management of Atrial Fibrillation in the Elderly

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References

  1. Heeringa J, van der Kuip DA, Hofman A, Kors JA, VanHerpen G, Stricker BHC, Stijnen T, Lip GYH, Witteman JCM. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27:e949–53.

    Article  Google Scholar 

  2. Donoghue OA, Jansen S, Dooley C, De Rooij S, Van DerVelde N, Kenny RA. Atrial fibrillation is associated with impaired mobility in community-dwelling older adults. J Am Med Dir Assoc. 2014;15(12):929–33.

    Article  PubMed  Google Scholar 

  3. Kirchhoff P, Ammenorp B, Darius H, et al. Management of atrial fibrillation in seven European countries after the publication of 2010 ESC guidelines for atrial fibrillation. Primary results of the PREvention of thromboembolic events—European registry in Atrial Fibrillation (PREFER in AF). Europace. 2014;16(1):6–14.

    Article  Google Scholar 

  4. Zallo MA. Atrial regulation of intravascular volume: observations on the tachycardia-Polyureasyndrome. Am Heart J. 1991;122(1 pt 1):188–94.

    Article  Google Scholar 

  5. Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology and rationale for therapy. Am J Cardiol. 2003;91(6A):2D–8D.

    Article  PubMed  Google Scholar 

  6. Boriani G, Laroche C, Diemberger I, et al. Asymptomatic atrial fibrillation: clinical correlates, management and outcomes in the EORP-AF pilot general registry. AM J Med. 2015;128(5):509–18.e2.

    Google Scholar 

  7. Benjamin EJ, Wolf PA, D’Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98(10):946–52.

    Article  CAS  PubMed  Google Scholar 

  8. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, LeHeuzey JY, Ponikowski P, Rutten FH. Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369–429.

    Article  Google Scholar 

  9. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation. Chest. 2010;137(2):263–72.

    Google Scholar 

  10. January CT, Wann LS, Alpert JS, Calkins H, Cleveland JC Jr, Cigarroa JE, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, Murray KT, Sacco RL, Stevenson WG, Tchou PJ, Tracy CM, Yancy CW. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1–76.

    Article  PubMed  Google Scholar 

  11. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093–100. doi:10.1378/chest.10-0134.

  12. Jacobs V, Cutler MJ, Day JD, Bunch TJ. Atrial fibrillation and dementia. Trends Cardiovasc Med. 2015;25(1):44–51.

    Article  PubMed  Google Scholar 

  13. Kazemian P, Oudit G, Jugdutt BI. Atrial fibrillation and heart failure in the elderly. Heart Fail Rev. 2012;17(4–5):597–613.

    Article  PubMed  Google Scholar 

  14. Hanon O, Assayag P, Belmin J, Collet JP, Emeriau JP, Fauchier L, Forette F, Friocourt P, Gentric A, Leclercq C, Komajda M, Le Heuzey JY, French Society of Geriatrics and Gerantology; French Society of Cardiology. Expert consensus of the French Society of Geriatrics and Gerontology and the French Society of Cardiology on the management of atrial fibrillation inelderly people. Arch Cardiovasc Dis. 2013;106(5):303–23.

    Article  PubMed  Google Scholar 

  15. Naderi S, Wang Y, Miller AL, Rodriguez F, Chung MK, Radford MJ, Foody JM. The impact of age on the epidemiology of atrial fibrillation hospitalizations. Am J Med. 2014;127(2):158.e1–7.

    Google Scholar 

  16. Kim MH, Johnston SS, Chu BC, Dalal MR, Schulman KL. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4:313–20.

    Article  PubMed  Google Scholar 

  17. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146:857–67.

    Article  PubMed  Google Scholar 

  18. Pokorney SD, Simon DN, Thomas L, Fonarow GC, Kowey PR, Chang P, Singer DE, Ansell J, Blanco RG, Gersh B, Mahaffey KW, Hylek EM, Go AS, Piccini JP, Peterson ED, Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Investigators. Patients’ time in therapeutic range on warfarin among US patients with atrial fibrillation: results from ORBIT-AF registry. Am Heart J. 2015;170(1):141–148., 148.e1, Epub 1 Apr 2015. doi:10.1016/j.ahj.2015.03.017.

    Article  PubMed  Google Scholar 

  19. Spivey CA, Qiao Y, Liu X, Mardekian J, Parker RB, Phatak H, Claflin AB, Kachroo S, Abdulsattar Y, Chakrabarti A, Wang J. Discontinuation/interruption of warfarin therapy in patients with nonvalvular atrial fibrillation. J Manag Care Spec Pharm. 2015;21(7):596–606.

    Article  PubMed  Google Scholar 

  20. Fang MC, Go AS, Chang Y, Borowsky LH, Pomernacki NK, Udaltsova N, Singer DE. Warfarin discontinuation after starting warfarin for atrial fibrillation. Circ Cardiovasc Qual Outcomes. 2010;3(6):624–31.

    Article  PubMed  PubMed Central  Google Scholar 

  21. da Silva RM. Novel oral anticoagulants in non-valvular atrial fibrillation. Cardiovasc Hematol Agents Med Chem. 2014;12(1):3–8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383(9921):955–62.

    Article  CAS  PubMed  Google Scholar 

  23. Brignole M, Menozzi C, Gasparini M, Bongiorni MG, Botto GL, Ometto R, Alboni P, Bruna C, Vincenti A, Verlato R, PAF 2 Study Investigators. An evaluation of the strategy of maintenance of sinus rhythm by antiarrhythmic drug therapy after ablation and pacing therapy in patients with paroxysmal atrial fibrillation. Eur Heart J. 2002;23:892–900.

    Article  CAS  PubMed  Google Scholar 

  24. Carlsson J, Miketic S, Windler J, et al. Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillations: (STAF) strategies of treatment of atrial fibrillation study. J Am Coll Cardiol. 2003;41:1690–6.

    Article  PubMed  Google Scholar 

  25. Hohnloser SH, Kuck KH, Lilienthal J. Rhythm or rate control in atrial fibrillation—pharmacological intervention in atrial fibrillation (PIAF): a randomised trial. Lancet. 2000;356:1789–94.

    Article  CAS  PubMed  Google Scholar 

  26. Van Gelder IC, Hagens VE, Bosker HA, et al. Rate control versus electrical cardioversion for persistent atrial fibrillation (RACE) study group. N Engl J Med. 2002;347:1834–40.

    Article  PubMed  Google Scholar 

  27. Wyse DG, Waldo AL, DiMarco JP, et al. The atrial fibrillation follow-up investigation of rhythm management (AFFIRM) investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347:1825–33.

    Article  CAS  PubMed  Google Scholar 

  28. Jenkins LS, for the NHLBI AFFIRM Quality of Life Substudy Investigators. Quality of life in patients with atrial fibrillation and risk factors for stroke and death: an AFFIRM substudy. PACE 2002. Presented at annual scientific sessions of the north American Society of Pacing and Electrophysiology as a late-breaking clinical trial; May 11, 2002, San Diego, CA.

    Google Scholar 

  29. Gronefeld GC, Lilienthal J, Kuck KH, Hohnloser SH, for the Pharmacological Intervention in Atrial Fibrillation (PIAF) Study Group. Impact of rate versus rhythm control on quality of life in patients with persistent atrial fibrillation. Results from a prospective randomized trial. Eur Heart J. 2003;24:1430–6.

    Article  PubMed  Google Scholar 

  30. Marshall AD, Levy AR, Vidaillet H, et al. Cost-effectivenessof rhythm versus rate control for treatment of atrial fibrillation: results from the AFFIRM study. Ann Intern Med. 2004;141:653–61.

    Article  PubMed  Google Scholar 

  31. Shariff N, Desai RV, Patel K, Ahmed MI, Fonarow GC, Rich MW, Aban IB, Banach M, Love TE, White M, Aronow WS, Epstein AE, Ahmed A. Rate-control versus rhythm-control strategies and outcomes in septuagenarians with atrial fibrillation. Am J Med. 2013;126(10):887–93.

    Article  PubMed  Google Scholar 

  32. Klein AL, Grimm RA, Murray RD, Apperson-Hansen C, Asinger RW, Black IW, Davidoff R, Erbel R, Halperin JL, Orsinelli DA, Porter TR, Stoddard MF. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med. 2001;344:1411–20.

    Article  CAS  PubMed  Google Scholar 

  33. Lafuente-Lafuente C, Mouly S, Longás-Tejero M, Mahé I, Bergmann J. Antiarrhythmic drugs for maintaining sinus rhythm after cardioversion of atrial fibrillation: a systematic review of randomized controlled trials. Arch Intern Med. 2006;166(7):719–28.

    Article  CAS  PubMed  Google Scholar 

  34. Van Gelder IC, Groenveld HF, Crijns HJ, Tuininga YS, Tijssen JG, Alings AM, Hillege HL, Bergsma-Kadijk JA, Cornel JH, Kamp O, Tukkie R, Bosker HA, Van Veldhuisen DJ, Van den Berg MP, RACE II Investigators. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010;362(15):1363–73.

    Article  PubMed  Google Scholar 

  35. Groenveld HF, Tijssen JG, Crijns HJ, Van den Berg MP, Hillege HL, Alings M, Van Veldhuisen DJ, Van Gelder IC, RACE II Investigators. Rate control efficacy in permanent atrialfibrillation: successful and failed strict rate control against a background of lenient rate control: data from RACE II (rate control efficacy in permanent atrial fibrillation). J Am Coll Cardiol. 2013;61(7):741–8.

    Article  PubMed  Google Scholar 

  36. Bunch TJ, Weiss JP, Crandall BG, May HT, Bair TL, Osborn JS, Anderson JL, Lappe DL, Muhlestein JB, Nelson J, Day JD. Long-term clinical efficacy and risk of catheter ablation for atrial fibrillation in octogenarians. Pacing Clin Electrophysiol. 2010;33(2):146–52.

    Article  PubMed  Google Scholar 

  37. Takigawa M, Takahashi A, Kuwahara T, Okubo K, Takahashi Y, Watari Y, Takagi K, Fujino T, Kimura S, Hikita H, Tomita M, Hirao K, Isobe M. Long-term follow-up after catheter ablation of paroxysmal atrial fibrillation: the incidence of recurrence and progression of atrial fibrillation. Circ Arrhythm Electrophysiol. 2014;7(2):267–73.

    Article  PubMed  Google Scholar 

  38. Nademanee K, Amnueypol M, Lee F, Drew CM, Suwannasri W, Schwab MC, Veerakul G. Benefits and risks of catheter ablation in elderly patients with atrial fibrillation. Heart Rhythm. 2015;12(1):44–51.

    Article  PubMed  Google Scholar 

  39. Nakamura T, Izutani H, Sawa Y. Mid-term outcomes of the modified Cox-maze procedure for elderly patients: a risk analysisfor failure. Interact Cardiovasc Thorac Surg. 2011;12(6):924–8.

    Article  PubMed  Google Scholar 

  40. Van Wagoner DR, Piccini JP, Albert CM, Anderson ME, Benjamin EJ, Brundel B, Califf RM, Calkins H, Chen PS, Chiamvimonvat N, Darbar D, Eckhardt LL, Ellinor PT, Exner DV, Fogel RI, Gillis AM, Healey J, Hohnloser SH, Kamel H, Lathrop DA, Lip GY, Mehra R, Narayan SM, Olgin J, Packer D, Peters NS, Roden DM, Ross HM, Sheldon R, Wehrens XH. Progress toward the prevention and treatment of atrial fibrillation: a summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9–10, 2013. Heart Rhythm. 2015;12(1):e5–e29.

    Article  PubMed  Google Scholar 

  41. Holmes DR Jr, Doshi SK, Kar S, Price MJ, Sanchez JM, Sievert H, Valderrabano M, Reddy VY. Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: a patient-level meta-analysis. J Am Coll Cardiol. 2015;65(24):2614–23. doi:10.1016/j.Jacc.2015.04.025.

    Article  PubMed  Google Scholar 

  42. Meier B, Blaauw Y, Khattab AA, Lewalter T, Sievert H, Tondo C, Glikson M. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. EuroIntervention. 2015;10(9):1109–25.

    Article  PubMed  Google Scholar 

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Correspondence to Syamkumar M. Divakara Menon M.B., M.D., D.M., M.Sc. .

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Divakara Menon, S.M. (2018). Special Problems in Management of Atrial Fibrillation in the Elderly. In: Nair, B. (eds) Geriatric Medicine. Springer, Singapore. https://doi.org/10.1007/978-981-10-3253-0_15

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