Managing atrial fibrillation in the very elderly patient: challenges and solutions.

作者: Konstantinos Letsas , Nikolaos Karamichalakis , Konstantinos Vlachos , Stamatis Georgopoulos , Athanasios Bakalakos

DOI: 10.2147/VHRM.S83664

关键词: Catheter ablationMedicineAtrial AppendageQuality of lifeCardiac catheterizationSinus rhythmPopulationAtrial fibrillationIntensive care medicinePercutaneous

摘要: Atrial fibrillation (AF) is the most common arrhythmia affecting elderly patients. Management and treatment of AF in this rapidly growing population older patients involve a comprehensive assessment that includes comorbidities, functional, social status. The cornerstone therapy thromboembolic protection. Anticoagulation has evolved, using conventional or newer medications. Percutaneous left atrial appendage closure new invasive procedure evolving as an alternative to systematic anticoagulation therapy. Rate rhythm control leads relief symptoms, fewer hospitalizations, improvement quality life. Invasive methods, such catheter ablation, are frontier maintaining even sinus particular population.

参考文章(73)
Krzysztof Bartus, Frederick T. Han, Jacek Bednarek, Jacek Myc, Boguslaw Kapelak, Jerzy Sadowski, Jacek Lelakowski, Stanislaw Bartus, Steven J. Yakubov, Randall J. Lee, Percutaneous Left Atrial Appendage Suture Ligation Using the LARIAT Device in Patients With Atrial Fibrillation: Initial Clinical Experience Journal of the American College of Cardiology. ,vol. 62, pp. 108- 118 ,(2013) , 10.1016/J.JACC.2012.06.046
Nikolaos Dagres, Robby Nieuwlaat, Panos E. Vardas, Dietrich Andresen, Samuel Lévy, Stuart Cobbe, Dimitrios Th. Kremastinos, Günter Breithardt, Dennis V. Cokkinos, Harry J.G.M. Crijns, Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: a report from the Euro Heart Survey on Atrial Fibrillation. Journal of the American College of Cardiology. ,vol. 49, pp. 572- 577 ,(2007) , 10.1016/J.JACC.2006.10.047
Tamás Fazekas, The concise history of atrial fibrillation Orvostorteneti kozlemenyek. ,vol. 53, pp. 37- 68 ,(2007)
Peter C. Block, Steven Burstein, Paul N. Casale, Paul H. Kramer, Paul Teirstein, David O. Williams, Mark Reisman, Percutaneous Left Atrial Appendage Occlusion for Patients in Atrial Fibrillation Suboptimal for Warfarin Therapy JACC: Cardiovascular Interventions. ,vol. 2, pp. 594- 600 ,(2009) , 10.1016/J.JCIN.2009.05.005
Valsartan for Prevention of Recurrent Atrial Fibrillation The New England Journal of Medicine. ,vol. 360, pp. 1606- 1617 ,(2009) , 10.1056/NEJMOA0805710
Jorge Romero, Andrea Natale, Krysthel Engstrom, Luigi Di Biase, Left atrial appendage isolation using percutaneous (endocardial/epicardial) devices: Pre-clinical and clinical experience. Trends in Cardiovascular Medicine. ,vol. 26, pp. 182- 199 ,(2016) , 10.1016/J.TCM.2015.05.009
Fabian Nietlispach, Steffen Gloekler, René Krause, Samera Shakir, Michael Schmid, Ahmed A. Khattab, Peter Wenaweser, Stephan Windecker, Bernhard Meier, Amplatzer left atrial appendage occlusion: single center 10-year experience. Catheterization and Cardiovascular Interventions. ,vol. 82, pp. 283- 289 ,(2013) , 10.1002/CCD.24872
Konstantinos P. Letsas, Michael Efremidis, Spyridon Deftereos, Georgios Giannopoulos, Vasileios Kareliotis, Konstantinos Vlachos, Antonios Sideris, Louiza Lioni, Catheter ablation of atrial fibrillation in the elderly Journal of Geriatric Cardiology. ,vol. 11, pp. 291- 295 ,(2014) , 10.11909/J.ISSN.1671-5411.2014.04.003
Carlo de Asmundis, Antonio Sorgente, Roberto De Ponti, Stephan-Andreas Muller-Burri, Yoshinao Yazaki, Andrea Sarkozy, Gaetano Paparella, Pedro Brugada, Gian Battista Chierchia, Lucio Capulzini, Fatih Bayrak, Marc Lameir, Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Septuagenarians: a Prospective Study Indian pacing and electrophysiology journal. ,vol. 10, pp. 393- 399 ,(2010)
Pär Hallberg, Johan Lindbäck, Bertil Lindahl, Ulf Stenestrand, Håkan Melhus, , Digoxin and mortality in atrial fibrillation: a prospective cohort study European Journal of Clinical Pharmacology. ,vol. 63, pp. 959- 971 ,(2007) , 10.1007/S00228-007-0346-9