Clinical Characteristics and Management in Elderly Patients with Atrial Fibrillation

ABSTRACT

BACKGROUND: Atrial fibrillation is the most common sustained arrhythmia especially in the elderly. Despite the beneficial effect of anticoagulation to prevent disastrous complication of throm-boembolism, anticoagulation is not widely used in patients with atrial fibrillation. The purpose of this study was to identify the prevalence and clinical characteristics of atrial fibrillation and investigate the current status of anticoagulation in the elderly. METHODS: Through electrocardiographic analysis of 6,138 elderly (> or =65yr) patients from tan. to Dec. 1997, 386 patients with atrial fibrillation was found. Among the 386 patients, 274 patients with available medical records were enrolled for review of clinical findings (associated diseases, risk factor of throm-boembolism, medications) retrospectively. RESULTS: Mean age of population with atrial fibrillation was 72+/-6yr. The prevalence of atrial fibrillation was 6.2% and increased with age (65-69yr 5.4%, 70-74yr 6.4%, 75-79yr 7.5%, 80yr-9.0%). Atrial fibrillation with valvular hear disease was 27% of patients. Common associated diseases with nonvalvular atrial fibrillation were hypertension (48%), diabetes mellitus (18%), coronary artery disease (25%), congestive heart failure (21%), history of stroke or transient ischemic attack (27%). Anti-coagulation was used in 59% of valvular atrial fibrillation patients without contraindications (prosthetic valve 100%, native valve 42%), 24% of nonval-vular atrila fibrillation. Antiplatelet therapy with aspirin was 15%, 30% respectively, Aspirin was used in only 20% of atrial fibrillation patients with contraindication of anticoagulation. CONCLUSION: Atrial fibrillation is prevalent in the elderly. Anticoagulation and antiplatelet therapy in atrial fibrillation appears to be less than optimal.