Ultrasensitive cardiac troponin assay and atrial fibrillation in the elderly population

2012 ◽  
Vol 3 ◽  
pp. S98
Author(s):  
F. Attanasio ◽  
V. Giantin ◽  
A. Franchin ◽  
A. Rossi ◽  
M.M. Mion ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Troponin ◽  
Elderly Population ◽  
The Elderly

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

2018 ◽  
Vol 88 (2) ◽  
Author(s):  
Giovanni Luca Botto ◽  
Carlo Piemontese ◽  
Giovanni Russo
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Patient ◽  
Rate Control ◽  
Ischemic Cardiomyopathy ◽  
Elderly Population ◽  
Antiarrhythmic Drugs ◽  
Treatment Options ◽  
The Elderly ◽  
Rhythm Control ◽  
Abnormal Rate

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.

Abstract 249: Medical Cost Avoidance among the General and Elderly Atrial Fibrillation Populations Differs According to Specific Anticoagulant Use, Based on the ARISTOTLE and RE-LY Trials

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Alpesh Amin ◽  
Steve Deitelzweig ◽  
Yonghua Jing ◽  
Dinara Makenbaeva ◽  
Daniel Wiederkehr ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Major Bleeding ◽  
Medical Cost ◽  
Elderly Population ◽  
The Elderly ◽  
Medical Costs ◽  
Cost Avoidance ◽  
Weighted Averages ◽  
Event Rates

Introduction: The randomized ARISTOTLE and RE-LY clinical trials demonstrated that the new oral anticoagulants (NOACs) apixaban and dabigatran were effective and safe options for stroke prevention among non-valvular atrial fibrillation (AF) patients. It is unclear how the use of NOACs for the treatment of AF affects total medical costs. Hypothesis: This study evaluates the hypothesis that medical costs associated with the use of apixaban and dabigatran vs. warfarin are different among the general and elderly AF populations. Methods: Clinical event rates in patients receiving warfarin, apixaban, and dabigatran were estimated for the general and elderly (age ≥ 75 years) AF patient populations. Event rates associated with warfarin were calculated as weighted averages from NOAC trials among AF patients; NOAC rates were estimated by adjusting trial hazard ratios to these weighted averages. Annual incremental costs among patients with clinical events from the US payer perspective were obtained from published literature and inflation adjusted to 2010 cost levels. Medical cost avoidance was evaluated for each NOAC vs. warfarin. Results: Compared to warfarin, apixaban-mediated total medical cost reductions (Table) in both populations were driven by decreased major bleeding excluding hemorrhagic stroke (MBEHS) and stroke and systemic embolism (SSE). Dabigatran use reduced costs for the general population and increased costs for the elderly population; cost reduction in the general population was primarily due to reduced SSE while cost increase in the elderly population was primarily due to increased MBEHS. MI, PE or DVT, and non-major bleeding each made smaller contributions to the cost differences among both populations. Conclusions: Compared to warfarin, apixaban use may be associated with reduced medical costs in both general and elderly AF populations. Dabigatran use may be associated with a reduction of medical costs in the general AF population, but increased medical costs among the elderly.

scholarly journals Relationship between 24- hour Holter variables, chest discomfort and syncope: Does age matter?

2015 ◽  
Vol 1 (2) ◽  
pp. 90
Author(s):  
Samir Saha
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Population ◽  
Human Subjects ◽  
Tertiary Care ◽  
Holter Monitoring ◽  
The Elderly ◽  
Cardiac Events ◽  
Tertiary Care Centers ◽  
Rate Profile

One hundred and forty four ambulatory, non-emergent human subjects from 20-88 years of age were investigated following<br />routine 24 hour Holter monitoring referred by primary and tertiary care centers primarily for evaluation of palpitations<br />and syncope. The patients were grouped into 3 different age categories: A) 20-59 years of age (16%), B) 60-69 years<br />of age (26.4%) and C) &gt; 70 years of age (57.6%). Heart rate profile, RR intervals, symptoms, frequency of premature<br />supra ventricular and ventricular complexes were registered. The data show that though the occurrence and frequency<br />of premature atrial and ventricular contractions over a period of 24 hours did not differ between the groups, the younger<br />subjects documented more subjective discomforts during the Holter monitoring. Extra-systoles in excess of 1000 beats / 24<br />hour occured incessantly throughout the registration. Patients with syncope and those without did not differ as regards the<br />Holter variables. However, subjects with atrial fibrillation had acceptable rate control and had significantly lower incidence<br />of syncope than those with sinus rhythm. The findings suggest that in a county setting, Holter monitoring for evaluation of<br />syncope may not be the first hand mode of investigation in a non emergent setting. On the contrary, the modality appears<br />to be valuable for monitoring patients with atrial fibrillation. Even mild symptoms in the elderly population may warrant closer<br />clinical follow up to prevent cardiac events and/or syncope leading to serious physical injury.

scholarly journals Cross-sectional Association Between Blood Pressure Status and Atrial Fibrillation in an Elderly Chinese Population

2019 ◽  
Vol 32 (8) ◽  
pp. 777-785 ◽  
Author(s):  
Yi Chen ◽  
Qi-Fang Huang ◽  
Chang-Sheng Sheng ◽  
Lei Lei ◽  
Shao-Kun Xu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Chinese Population ◽  
Elderly Population ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Present Cross Sectional Study ◽  
Diastolic Hypertension ◽  
Elderly Chinese

Abstract OBJECTIVE Atrial fibrillation (AF) and hypertension are prevalent chronic disease conditions in the elderly population. In the present cross-sectional study, we investigated the association between blood pressure (BP) and AF in an elderly Chinese population. METHOD Our elderly (≥65 years) subjects were residents recruited from 6 communities in Shanghai from 2006 to 2017. Atrial fibrillation was systematically screened by rest 12-lead electrocardiogram (ECG) or by a handheld single-lead ECG. BP status was defined according to the European hypertension guidelines as optimal, normal, or high-normal BP, and stage 1, 2, or 3 hypertension. RESULT In the 6,966 participants (women 56.0%, mean age: 72.3 years), the prevalence of AF was 3.3%, and the prevalence of hypertension was 58.7% (83.7% treated). In all participants, the association with prevalent AF was negative for systolic BP (odds ratio [OR] per 10-mm Hg increase 0.79, 95% confidence interval [CI]: 0.71–0.88, P < 0.0001) but positive for diastolic BP (OR per 5-mm Hg increase 1.11, 95% CI: 1.02–1.22, P = 0.02). In untreated participants (n = 3,544), the association with prevalent AF was U-shaped for both systolic and diastolic BP, with the nadir at high-normal BP and a significantly higher risk of prevalent AF in optimal systolic BP (OR: 3.11, 95% CI: 1.65–5.85, P = 0.004) and stage 2 or 3 diastolic hypertension relative to the nadir (OR: 8.04, 95% CI: 2.28–28.3, P = 0.001). CONCLUSION In the elderly population, BP shows a complicated relationship with prevalent AF, with high-normal BP at the lowest risk and optimal systolic BP and stage 2 or 3 diastolic hypertension at increased risks.

scholarly journals Lower dementia risk with anticoagulation and ablation in patients with atrial fibrillation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daehoon Kim ◽  
Pil-Sung Yang ◽  
Boyoung Joung
Keyword(s):  
Atrial Fibrillation ◽  
Cognitive Decline ◽  
Elderly Population ◽  
Oral Anticoagulants ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
The Elderly ◽  
Vitamin K Antagonist ◽  
Dementia Risk ◽  
Increased Risk

AbstractAtrial fibrillation (AF), the most common cardiac arrhythmia in the elderly population, has been associated with an impairment of cognitive function and an increased risk of dementia. Even though there does not appear to be solid evidence that any specific treatment prevents or delays AF-associated cognitive decline, evidence is accumulating regarding the possible treatment strategies for preventing dementia. Oral anticoagulation, especially non-vitamin K antagonist oral anticoagulants rather than warfarin use, has been suggested to be associated with reduced risk of dementia. Successfully maintaining sinus rhythm using catheter ablation might be also helpful in preventing subsequent dementia in patients with AF. In this review, we critically appraise the proposed treatment strategies for preventing AF-associated cognitive decline.

scholarly journals Atrial fibrillation: a risk factor for unfavourable outcome in COVID-19? A case report

2020 ◽  
Vol 4 (FI1) ◽  
pp. 1-6 ◽  
Author(s):  
Sebastian Schnaubelt ◽  
Marie-Kathrin Breyer ◽  
Jolanta Siller-Matula ◽  
Hans Domanovits
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Elderly Population ◽  
Kidney Injury ◽  
The Elderly ◽  
Pericardial Tamponade ◽  
Rhythm Control ◽  
Unfavourable Outcome ◽  
Progressive Heart Failure ◽  
Case Summary

Abstract Background Fulminant cardiac involvement in COVID-19 patients has been reported; the underlying suspected mechanisms include myocarditis, arrhythmia, and cardiac tamponade. In parallel, atrial fibrillation is common in the elderly population which is at particularly high risk for COVID-19 morbidity and mortality. Case summary A 72-year-old male SARS-CoV2-positive patient was admitted to the intensive care unit due to delirium and acute respiratory failure. Atrial fibrillation known from history was exacerbated, and made complex rate and rhythm control necessary. Progressive heart failure with haemodynamic deterioration and acute kidney injury with the need for continuous renal replacement therapy were further aggravated by pericardial tamponade. Discussion Treatment of acute heart failure in COVID-19 patients with a cytokine storm complicated by tachycardic atrial fibrillation should include adequate rate or rhythm control, and potentially immunomodulation.

scholarly journals Atrial fibrillation in the elderly population: Challenges and management considerations

2021 ◽  
Author(s):  
Mohammed Salih ◽  
Osama Abdel‐Hafez ◽  
Ramzi Ibrahim ◽  
Rajiv Nair
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Population ◽  
The Elderly
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