[Chronic atrial fibrillation in the elderly].

PURPOSE

To evaluate the different aspects of chronic atrial fibrillation (CAF) in elderly patients.

METHODS

Forty nine patients with CAF (18 men) aged 66 to 87 years (76.1 years on average) were studied. Their evaluation consisted of clinical examination, blood tests, electrocardiogram, chest X-Ray and echocardiogram.

RESULTS

The frequency of CAF in the out-patient Geriatric Clinic was 4.8% and it rose with aging. Cardiocirculatory diseases were observed in 39 (79.6%) patients: 25 (51.0%) had systemic arterial hypertension, 11 (22.4%) had mitral valve disease and six (11.2%) had aortic valve disease. Thirty patients had diseases of other systems, eight (16.3%) of whom were diabetic and seven (14.3%) had hyperthyroidism. Vascular brain disease was observed in four (8.2%) patients. Electrocardiographic changes other than CAF were observed in 41 (83.7%) patients. Changes in the ST-T segment were the more frequent, being observed in 28 (57.1%) patients, followed by left ventricular hypertrophy in 15 (30.1%). Cardiomegaly was seen in 36 (78.3%) out of 46 patients who did the chest radiography. An echocardiogram was performed in 35 patients, being found normal in seven (20.0%). In the remaining cases, the abnormality more frequently seen was the left atrial enlargement, seen in 16 (45.7%) patients. Four patients didn't show clinical, electrocardiographic, radiological or echocardiographic evidence of cardiocirculatory disease and in these, the thyroid function was normal. Digitalis therapy was used in 37 patients. Of the remaining 12, 10 had normal ventricular frequency without the use of the drug.

CONCLUSION

The CAF in the elderly patient is observed not only in patients with cardiocirculatory diseases, but in thyrotoxic patients and sometimes without known etiology.