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Acta Médica Costarricense

On-line version ISSN 0001-6002Print version ISSN 0001-6012


BRIZUELA-TORRES, Jorge  and  MORALES-MARTINEZ, Fernando. Atrial Fibrillation in the Elderly. Acta méd. costarric [online]. 2009, vol.51, n.3, pp.138-146. ISSN 0001-6002.

Atrial fibrillation is the most prevalent arrhythmia in the elderly. Its frequency increases with age, being 1.5% from 50 to 59 years old and 10% from 80 to 89 years old. Non valvular atrial fibrillation increases 5 fold the risk of suffering an stroke and causes 15% of strokes in the USA. Atrial fibrillation management focuses in the prevention of thromboembolic phenomena and heart rate and rhythm control. Anticoagulation, when indicated, has demonstrated to be the main tool in the prevention of these events. Nevertheless, although bleeding complications are more frequent in this population and increase with age, anticoagulation benefits are greater than the risks. Heart rate control is better than rhythm control regarding cerebrovascular accidents and mortality. Age by itself is not a contraindication to offer optimal therapy. Functional, mental and social status, must be taken into account as well as physiological aspects of aging when it comes to prescribing medications. If symptoms persist in spite of adequate treatment, invasive strategies have demonstrated to be of benefit, however studies in elderly population are lacking.

Keywords : atrial fibrillation; elderly; anticoagulation; prevention; antiplatelet agents; stroke.

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