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Review
. 2022 Feb;13(1):5-18.
doi: 10.1007/s41999-021-00537-w. Epub 2021 Nov 2.

Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines

M Cristina Polidori  1   2 , Mariana Alves  3   4   5 , Gulistan Bahat  6 , Anne Sophie Boureau  7 , Serdar Ozkok  6 , Roman Pfister  8 , Alberto Pilotto  9   10 , Nicola Veronese  11 , Mario Bo  12 ; Special Interest Group “Cardiovascular Diseases” of the EuGMS
Affiliations
Review

Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines

M Cristina Polidori et al. Eur Geriatr Med. 2022 Feb.

Abstract

Background: The Task Force for the diagnosis and management of atrial fibrillation (AF) of the European Society of Cardiology (ESC) published in 2020 the updated Guidelines for the Diagnosis and Management of Atrial Fibrillation with the contribution of the European Heart Rhythm Association (EHRA) of the ESC and the European Association for Cardiothoracic Surgery (EACTS).

Methods and results: In this narrative viewpoint, we approach AF from the perspective of aging medicine and try to provide the readers with information usually neglected in clinical routine, mainly due to the fact that while the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians' attitudes often prevail over standardized algorithms.

Conclusions: On the basis of existing evidence, (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehensive Geriatric Assessment (CGA) including frailty, cognitive impairment, falls and bleeding risk may assist in clinical decision making to provide the best individualized treatment.

Keywords: Advanced age; Anticoagulation; Atrial fibrillation; Cognitive impairment; Older patients.

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Conflict of interest statement

Nothing to declare.

References

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