Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines.
Advanced age
Anticoagulation
Atrial fibrillation
Cognitive impairment
Older patients
Journal
European geriatric medicine
ISSN: 1878-7649
Titre abrégé: Eur Geriatr Med
Pays: Switzerland
ID NLM: 101533694
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
29
04
2021
accepted:
03
07
2021
pubmed:
3
11
2021
medline:
1
4
2022
entrez:
2
11
2021
Statut:
ppublish
Résumé
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). 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 34727362
doi: 10.1007/s41999-021-00537-w
pii: 10.1007/s41999-021-00537-w
pmc: PMC8562074
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
5-18Informations de copyright
© 2021. The Author(s).
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