The prevalence of atrial fibrillation (AF) increases with aging. It is associated with serious health consequences. The degenerative changes and the comorbidities result in anatomical substrate for this arrhythmia. Patients over 65 years old have higher embolic risk. Prescription of non-vitamin K antagonists is recommended after evaluation of the hemorrhagic risk as well. The preferred strategy – rhythm or rate control is selected based on the patient’s characteristics. Rhythm control is performed by electrical cardioversion, pharmacological cardioversion or ablation. For rate control, beta-blockers are mostly recommended.
Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J, 2016; 37( 38):2893–2962, https://doi.org/10.1093/eurheartj/ehw210
Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S. Epidemiology of atrial fibrillation: European perspective. Clin Epidemiol. 2014: 6:213–220
Krijthe BP, Kunst A, Benjamin EJ, Lip GY, Franco OH et al Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J. 2013 Sep; 34(35):2746-51
Chatap, G., Giraud, K. & Vincent, JP. Atrial Fibrillation in the Elderly Facts and Management. Drugs Aging, 2002; 19:819. https://doi.org/10.2165/00002512-200219110-00002
Marzona I, O’Donnell M, Teo K, Gao P, Anderson C et al. Increased risk of cognitive and functional decline in patients with atrial fibrillation: results of the ONTARGET and TRANSCEND studies. CMAJ 2012: 184:E329–336.
Wolf PA Abbott RD, Kannel WB. Atrial Fibrillation as an Independent Risk Factor for Stroke: The Framingham Study. Stroke. 1991: 22: 983-988 011.
Thrall G, Lane D, Carroll D, Lip GY. Quality of life in patients with atrial fibrillation: a systematic review. Am J Med. 2006: 119:448.e1–19.
Vaziri M, Larson MG, Benjamin EJ, et al. Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Study. Circulation 1994; 89: 724-30
Burstein B, Nattel S. Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation. J Am Coll Cardiol. 2008; 51:802–9. doi: 10.1016/j.jacc.2007.09.064
Kisheva A. Role of fibrosis and blocking of mineralcorticoid receptors in atrial fibrillation. PhD Thesis, 2017, Medical University, Varna, Bulgaria.
Кишева А, Йотов Й, Сърдечна фиброза и роля на галектин-3 в диагностичната и прогностична оценка на сърдечно болните. Българска кардиология. 2012(4):14-19
Kisheva A, Yotov Y, Chervenkov T, Bocheva Y. Does gout matter in patients with atrial fibrillation? Journal of interventional cardiac electrophysiology, 2018; 51:S129-S130
Kisheva A, Mircheva L, Atrial fibrillation in cancer patients. Heart-Lung (Varna), 2017; 23:32-36
Mircheva L, Panayotov P, Yotov Y, Kisheva A, Donchev N, Pashev V, Degenerative mitral valve disease. Heart-Lung (Varna), 2016; 22:3-12
Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects: the Cardiovascular Health Study. Am J Cardiol 1994; 74: 236-41
Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults. JAMA 2001; 285: 2370-5
The AFFIRM Investigators. Baseline characteristics of patients with atrial fibrillation: the AFFIRM Study. Am Heart J 2002; 143: 991-1001
Кишева А, Йотов Й, Ангелов А, Мирчева Л, Кунчев О, Пенев А. Оценка на риска и антикоагулантно лечение при болни с неклапно предсърдно мъждене в болнични условия. 2012; 17:21-24
LinL,LimWS,ZhouHJ,KhooAL,TanKT,ChewAP,etal.Clinicalandsafety outcomes of oral antithrombotics for stroke prevention in atrial fibrillation: a systematic review and network meta-analysis. J Am Med Dir Assoc. 2015; 16:1103 e1–19. doi: 10.1016/j.jamda.2015.09.008
Sharma M, Cornelius VR, Patel JP, Davies JG, Molokhia M. Efficacy and harms of direct oral anticoagulants in the elderly for stroke prevention in atrial fibrillation and secondary prevention of venous thromboembolism: systematic review and meta-analysis. Circulation, 2015; 132:194–204. doi: 10.1161/CIRCULATIONAHA.114.013267
Metzner I, Wissner E, Tilz R, Rillig A, Mathew S et al. Ablation of atrial fibrillation in patients ≥75 years: long-term clinical outcome and safety, EP Europace; 2016; 18(4): 543–549, https://doi.org/10.1093/europace/euv229
Kisheva A, Yotov Y, Angelov A, Penev A. Upstream therapy in atrial fibrillation. Heart-Lung (Varna), 2011; 17(3-4):3-13
Kisheva A, Yotov Y, Angelov A, Penev A. Upstream therapy in atrial fibrillation. Heart-Lung (Varna), 2011; 17(3-4):3-13
