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

Authors Karamichalakis N, Letsas K, Vlachos K, Georgopoulos S, Bakalakos A, Efremidis M, Sideris A

Received 18 July 2015

Accepted for publication 5 October 2015

Published 27 October 2015 Volume 2015:11 Pages 555—562

DOI https://doi.org/10.2147/VHRM.S83664

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Jaya Mallela

Peer reviewer comments 2

Editor who approved publication: Dr Daniel Duprez


Nikolaos Karamichalakis, Konstantinos P Letsas, Konstantinos Vlachos, Stamatis Georgopoulos, Athanasios Bakalakos, Michael Efremidis, Antonios Sideris

Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece

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

Keywords: elderly, atrial fibrillation, anticoagulation, drugs, catheter ablation

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