Rhythm-control vs rate-control in the elderly: When to do it and which drug to prefer?

• Main Authors: Giovanni Luca Botto, Carlo Piemontese, Giovanni Russo
• Format: Article
• Language: English
• Published: PAGEPress Publications 2018-06-01
• Series: Monaldi Archives for Chest Disease
• Subjects: Atrial fibrillation; rhythm control; rate control; antiarrhythmic drug.
• Online Access: https://www.monaldi-archives.org/index.php/macd/article/view/949

Atrial fibrillation (AF) is a relevant cardiovascular condition that is more prevalent in the elderly patients aged over 65 years. AF, with abnormal rate and rhythm can cause symptoms directly or indirectly by exacerbating other frequently coexisting cardiac conditions such as valvular heart disease, hypertension, ischemic cardiomyopathy, dilated cardiomyopathy, and hypertrophic cardiomyopathy. Evidence suggests that aging-related cardiovascular changes predispose to the elderly to AF. Current therapeutic options such as antiarrhythmic drugs have not been extensively evaluated in the elderly population. Emerging pharmacological and non-pharmacological treatment options for the management of AF, such as dronedarone or catheter ablation, are of particular interest in the elderly. The present paper reviews the pathophysiology, diagnosis, and the management of AF in the elderly patient.