Atrial fibrillation in very old patients

• Author(s): Vasconcelos, P ; Luz, I ; Heitor, S ; Bragança, N
• Date: 2012
• Persistent ID: http://hdl.handle.net/10400.10/754
• Origin: Repositório do Hospital Prof. Doutor Fernando Fonseca
• Subject(s): Fibrilhação auricular; Idoso; Atrial fibrillation; Elderly
• Document Type: Conference Object
• Language: English

Description

OBJECTIVES Atrial Fibrillation (AF) is the arrhythmia most often observed in elderly patients and is an important cause of morbidity and mortality in this age group. Anticoagulation to reduce the thromboembolic risk is an essential part of the approach of this pathology. In this context, our aim is to assess the prevalence of AF and its treatment in very old patients admitted to our medicine ward. MATERIAL AND METHOD We analyzed the clinical files of very old patients (VOP - very old people - age > or = life expectancy + 5 years for both sexes - 76 + 5 years for males and 82 + 5 years for females) admitted to our department from 01/01/2011 to 31/12/2011. The average of in ward days and death rate was calculated. We analyzed the electrocardiograms performed at baseline and assessed outpatient medication. RESULTS In 2011 we recorded 996 admissions, of which 189 (19%) were VOP. Of these, 26 (13.76%) died. The average hospitalization was found to be 15 days. We identified 61 cases (32%) with AF. No differences were found between genders. The majority (74%) had a CHADS2 score >2. Only 1/10 of patients were treated with oral anticoagulants. CONCLUSIONS The prevalence of AF in our sample is relatively high compared to that described in other epidemiological studies. Despite the higher risk of stroke in elderly patients, thromboprophylaxis in AF is suboptimal. We admit that the new oral anticoagulants, because they do not require monitoring and have less drug interactions can potentially become very useful, particularly in the elderly.