Parrini Iris, Lucà Fabiana, Rao Carmelo Massimiliano, Ceravolo Roberto, Gelsomino Sandro, Ammendolea Carlo, Pezzi Laura, Ingianni Nadia, Del Sindaco Donatella, Murrone Adriano, Geraci Giovanna, Bilato Claudio, Armentaro Giuseppe, Sciacqua Angela, Riccio Carmine, Colivicchi Furio, Grimaldi Massimo, Oliva Fabrizio, Gulizia Michele Massimo
Department of Cardiology, Mauriziano Hospital, 10128 Turin, Italy.
Department of Cardiology, Grande Ospedale Metropolitano (GOM) of Reggio Calabria, Bianchi Melacrino Morelli Hospital, 89129 Reggio Calabria, Italy.
J Clin Med. 2025 Mar 28;14(7):2328. doi: 10.3390/jcm14072328.
Atrial fibrillation (AF) is the most prevalent sustained supraventricular arrhythmia, particularly in older adults, with its incidence increasing dramatically with age. This condition is a significant contributor to morbidity and mortality, being closely linked to an elevated risk of heart failure, ischemic stroke, systemic thromboembolism, and dementia. The complexities of managing AF in the elderly arise from age-related physiological changes, comorbidities, frailty, and the challenges of polypharmacy. Therapeutic strategies must balance efficacy and safety, tailoring interventions to the individual's health status, life expectancy, and personal preferences. This review explores the latest evidence-based approaches to managing AF in elderly patients, focusing on the nuanced application of rate and rhythm control strategies, anticoagulation, and emerging insights into the relationship between AF and cognitive impairment.
心房颤动（AF）是最常见的持续性室上性心律失常，尤其在老年人中，其发病率随年龄急剧增加。这种疾病是发病和死亡的重要原因，与心力衰竭、缺血性中风、全身性血栓栓塞和痴呆症的风险升高密切相关。老年人房颤管理的复杂性源于与年龄相关的生理变化、合并症、虚弱以及多重用药的挑战。治疗策略必须平衡疗效和安全性，根据个体的健康状况、预期寿命和个人偏好量身定制干预措施。本综述探讨了老年患者房颤管理的最新循证方法，重点关注心率和节律控制策略、抗凝的细微应用，以及房颤与认知障碍之间关系的新见解。
