Fast Five Quiz: Anticoagulation in Older Patients With Atrial Fibrillation

Sandeep K. Goyal, MD


March 09, 2022

Both increased risk for falls and concomitant heart failure are common reasons for withholding anticoagulation therapy. Decreasing the risk for catastrophic thromboembolic events is a benefit that may outweigh the risks associated with falling and comorbidities. Left atrial appendage occlusion should be considered as a potential option if long-term anticoagulation is contraindicated. AF can be asymptomatic, discovered in the setting of an embolic event or during clinical evaluation, or symptomatic. In addition to instituting anticoagulation therapy to minimize risk for thromboembolism, management of AF in older patients should include rate control or rhythm control and assessment for changes in a patient's functional, cognitive, or clinical status. The STAF pilot study demonstrated no difference between rate control and rhythm control. About 35% of the participants in this study were 70 years of age or older. Management approaches should be individualized and should consider clinical and socioeconomic factors.

Learn more about management of AF.


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