Atrial fibrillation in the elderly

Teerapat Nantsupawat, Kenneth Nugent, Arintaya Phrommintikul

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Atrial fibrillation (AF) is the most common arrhythmia in older adults with a prevalence of 9 % in adults aged 80 years or older. AF patients have a five times greater risk of developing stroke than the general population. Using anticoagulants for stroke prevention in the elderly becomes a challenge because both stroke and bleeding complications increase with age. CHA2DS 2-VASc and HAS-BLED scores are currently used as stroke and bleeding risk evaluations. When the HAS-BLED score is 3 or higher, caution and efforts to correct reversible risk factors are advised. Regardless of the HAS-BLED score, warfarin or novel oral anticoagulants are a IIa recommendation for CHA 2DS2-VASc of 1, except for a score of 1 for females, and a IA recommendation for the score of 2 or higher. Aspirin is no longer recommended for AF thromboprophylaxis. In an elderly patient, lenient rate control is preferred over rhythm control owing to fewer adverse drugs effects and hospitalizations. When rhythm control is needed, dronedarone is a new antiarrhythmic drug that can be considered in patients who have paroxysmal AF and no history of heart failure. Although less efficacious than amiodarone, dronedarone has a fewer thyroid, neurologic, dermatologic, and ocular side effects than amiodarone.

Original languageEnglish (US)
Pages (from-to)593-601
Number of pages9
JournalDrugs and Aging
Issue number8
StatePublished - Aug 2013


Dive into the research topics of 'Atrial fibrillation in the elderly'. Together they form a unique fingerprint.

Cite this