Universität zu Köln

Polidori, M. Cristina, Alves, Mariana, Bahat, Gulistan, Boureau, Anne Sophie, Ozkok, Serdar, Pfister, Roman, Pilotto, Alberto, Veronese, Nicola and Bo, Mario ORCID: 0000-0003-2945-0243 (2022). Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines. Eur. Geriatr. Med., 13 (1). S. 5 - 19. NEW YORK: SPRINGER. ISSN 1878-7657

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Abstract

Background The Task Force for the diagnosis and management of atrial fibrillation (AF) of the European Society of Cardiology (ESC) published in 2020 the updated Guidelines for the Diagnosis and Management of Atrial Fibrillation with the contribution of the European Heart Rhythm Association (EHRA) of the ESC and the European Association for Cardiothoracic Surgery (EACTS). Methods and results In this narrative viewpoint, we approach AF from the perspective of aging medicine and try to provide the readers with information usually neglected in clinical routine, mainly due to the fact that while the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians' attitudes often prevail over standardized algorithms. Conclusions On the basis of existing evidence, (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehensive Geriatric Assessment (CGA) including frailty, cognitive impairment, falls and bleeding risk may assist in clinical decision making to provide the best individualized treatment. Key Summary PointsAim To provide a geriatric perspective on the 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Findings While the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians' attitudes often prevail over standardized algorithms. On the basis of existing evidence, we suggest that (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehesive Geriatric Assessment (CGA) including frailty, cognitive impairment, falls and bleeding risk may assist in clinical decision making to provide the best individualized treatment. Message The integration of CGA might positively influence clinical decision making in older patients with atrial fibrillation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Polidori, M. Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Alves, Mariana UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahat, Gulistan UNSPECIFIED UNSPECIFIED UNSPECIFIED Boureau, Anne Sophie UNSPECIFIED UNSPECIFIED UNSPECIFIED Ozkok, Serdar UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilotto, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Veronese, Nicola UNSPECIFIED UNSPECIFIED UNSPECIFIED Bo, Mario UNSPECIFIED orcid.org/0000-0003-2945-0243 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-601260
DOI:	10.1007/s41999-021-00537-w
Journal or Publication Title:	Eur. Geriatr. Med.
Volume:	13
Number:	1
Page Range:	S. 5 - 19
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1878-7657
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MULTIDIMENSIONAL PROGNOSTIC INDEX; VASCULAR RISK-FACTORS; ORAL ANTICOAGULANTS; STROKE PREVENTION; COGNITIVE DECLINE; FRAILTY SYNDROME; OLDER PATIENTS; BLEEDING RISK; PRIMARY-CARE; ASSOCIATION Multiple languages Geriatrics & Gerontology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60126