School of Medicine, Emory University, Atlanta, Georgia.
Cardiology Division, School of Medicine, Emory University, Atlanta, Georgia.
J Am Geriatr Soc. 2017 Jan;65(1):185-193. doi: 10.1111/jgs.14483. Epub 2016 Dec 2.
Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms. The evidence to support novel AF treatment strategies in elderly adults is reviewed, including novel oral anticoagulants and left atrial appendage closure for stroke risk reduction and catheter ablation for control of symptoms.
在很大程度上，人口老龄化以及与心房颤动（AF）相关的心血管合并症的患病率不断增加，导致老年人中 AF 的流行呈爆发式增长。尽管有大量文献可指导 AF 患者的管理，但老年人在临床试验中经常代表性不足。本综述提供了关于老年人 AF 管理的最新信息，特别关注 AF 带来的两个主要临床挑战：降低卒中风险和控制症状。本文回顾了支持新型 AF 治疗策略的证据，包括新型口服抗凝剂和左心耳封堵术降低卒中风险，以及导管消融术控制症状。
