[Cardiac arrhythmias in the elderly].
In the elderly, cardiac arrhythmias and conduction disturbances are characterized by their high frequency, diagnostic difficulties, low tolerance, and delicate treatment. Atrial fibrillation, the prevalence of which exceeds 10% after 80 years, is usually related to hypertensive or ischemic heart disease, and is the cause or the consequence of heart failure. It is first and foremost a cause of thromboembolic events, and especially cerebrovascular embolism. In elderly patients, sinus node dysfunction and AV block are often induced or aggravated by drugs. The iatrogenic risk associated with antiarrhythmic drugs (especially class I) and antithrombotic drugs is elevated in the elderly, and these agents must thus be used with great care. Ventricular rate control is often a safer option than sinus rhythm control for atrial fibrillation. Ablative methods and cardiac pacing techniques are other therapeutic options.
Guize
Louis
L
Service de Cardiologie A de l'Hôpital G. Pompidou, 20 rue Leblanc, 75015 Paris.
Piot
Olivier
O
Lavergne
Thomas
T
Le Heuzey
Jean-Yves
JY
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy; D001282:Atrial Flutter / Q000453:epidemiology / Q000628:therapy; D017115:Catheter Ablation; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006327:Heart Block / Q000139:chemically induced / Q000453:epidemiology / Q000628:therapy; D006329:Heart Conduction System / Q000502:physiology; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D015995:Prevalence; D012737:Sex Factors
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D005343:Fibrinolytic Agents