Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines

Polidori M. C., Alves M., Bahat G., Boureau A. S., Ozkok S., Pfister R., ...Daha Fazla

EUROPEAN GERIATRIC MEDICINE, cilt.13, sa.1, ss.5-18, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 13 Sayı: 1
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s41999-021-00537-w
  • Dergi Adı: EUROPEAN GERIATRIC MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.5-18
  • Anahtar Kelimeler: Atrial fibrillation, Advanced age, Older patients, Anticoagulation, Cognitive impairment, MULTIDIMENSIONAL PROGNOSTIC INDEX, VASCULAR RISK-FACTORS, ORAL ANTICOAGULANTS, STROKE PREVENTION, COGNITIVE DECLINE, FRAILTY SYNDROME, OLDER PATIENTS, BLEEDING RISK, PRIMARY-CARE, ASSOCIATION
  • İstanbul Üniversitesi Adresli: Evet

Özet

Background The Task Force for the diagnosis and management of atrial fibrillation (AF) of the European Society of Cardiology (ESC) published in 2020 the updated Guidelines for the Diagnosis and Management of Atrial Fibrillation with the contribution of the European Heart Rhythm Association (EHRA) of the ESC and the European Association for Cardiothoracic Surgery (EACTS). Methods and results In this narrative viewpoint, we approach AF from the perspective of aging medicine and try to provide the readers with information usually neglected in clinical routine, mainly due to the fact that while the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians' attitudes often prevail over standardized algorithms. Conclusions On the basis of existing evidence, (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehensive Geriatric Assessment (CGA) including frailty, cognitive impairment, falls and bleeding risk may assist in clinical decision making to provide the best individualized treatment.