Atrial Fibrillation in the Elderly: A Comprehensive Review

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia in the geriatric population, affecting approximately 5-15% of adults over 65 years of age. This review examines the geriatric considerations for frail older adults (≥60 years) to aid in diagnosis, thromboembolic and hemorrhagic risk stratification, and decision-making regarding anticoagulation, rate or rhythm control, catheter ablation, and non-pharmacological interventions through a Comprehensive Geriatric Assessment (CGA). This approach facilitates the selection of an individualized therapeutic plan, as a trend toward improved clinical outcomes has been observed when frailty, multimorbidity, and the preferences of this age group are considered.

Keywords: Atrial fibrillation, older adult, anticoagulation, catheter ablation, comprehensive geriatric assessment, frailty, thromboembolic risk.