Multimorbidity in Older Adults with Atrial Fibrillation.
Older adults with atrial fibrillation often have multiple comorbid conditions, including common geriatric syndromes. Pharmacologic therapy, whether for rate control or rhythm control, can result in complications related to polypharmacy in patients who are often on multiple medications for other conditions. Because of uncertainty about the relative risks and benefits of rate versus rhythm control (including antiarrhythmic or ablation therapy), anticoagulation, and procedural treatments (eg, ablation, left atrial appendage closure, pacemaker placement) in older patients with multimorbidity, shared decision-making is essential. However, this may be challenging in patients with cognitive dysfunction, high fall risk, or advanced comorbidity.
Cardiology, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Box 359748, Seattle, WA 98104, USA. Electronic address: michen@u.washington.edu.
Michael A
MA
Chen
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000066491:Clinical Decision-Making; D015897:Comorbidity; D006801:Humans; D000069342:Medical Overuse / Q000517:prevention & control*; D054539:Medication Therapy Management; D020379:Risk Adjustment; D018570:Risk Assessment
Atrial fibrillation; Geriatric syndromes; Multimorbidity; Older adults; Polypharmacy; Rate control; Rhythm control; Shared decision-making