期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 71, 期 18, 页码 2041-2057出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2018.03.019
关键词
ablation; antiarrhythmic drugs; electrophysiology; geriatrics; octogenarians
资金
- National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR001412]
- National Institutes of Health/National Heart, Lung, and Blood Institute [1K08HL131987]
Advances in medical care have led to an increase in the number of octogenarians and even older patients, forming an important and unique patient subgroup. It is clear that advancing age is an independent risk factor for the development of most arrhythmias, causing substantial morbidity and mortality. Patients >= 80 years of age have significant structural and electrical remodeling of cardiac tissue; accrue competing comorbidities; react differently to drug therapy; and may experience falls, frailty, and cognitive impairment, presenting significant therapeutic challenges. Unfortunately, very old patients are under-represented in clinical trials, leading to critical gaps in evidence to guide effective and safe treatment of arrhythmias. In this state-of-the-art review, we examine the pathophysiology of aging and arrhythmias and then present the available evidence on age-specific management of the most common arrhythmias, including drugs, catheter ablation, and cardiac implantable electronic devices. (C) 2018 by the American College of Cardiology Foundation.
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