Atrial fibrillation is more prevalent in the elderly population and the risk is more severe in older patients. These patients are characterized by frequent co-morbidities, very high risk of embolism and bleeding, more frequent chronic atrial fibrillation, often atypical symptoms, and ventricular rate insensitivity to sympathetic nervous system response. Hongliang Liu, Department of Geriatrics, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine
In terms of antithrombotic therapy in elderly patients with atrial fibrillation, Prof. Zhang has the following findings to share: (1) dual antiplatelet therapy in patients older than 70 years is superior to aspirin monotherapy but inferior to warfarin; (2) compared to warfarin, dabigatran 110 mg has a similar antithrombotic effect but a reduced risk of bleeding; dabigatran 150 mg has a similar risk of bleeding but a slightly better antithrombotic effect; (3) rivaroxaban The antithrombotic effect was not inferior to warfarin, but had a tendency to reduce serious bleeding events.
Finally, Prof. Zhang pointed out that catheter ablation is not yet the first-line treatment option for elderly patients with AF (especially those older than 75 years), who need more multidimensional and individualized treatment. Meanwhile, improvements in ablation techniques and devices, and the development of new drugs will likely improve the prognosis of elderly patients with AF, and the future direction of treatment for elderly AF may be staged.