Tactics of Antiarrhythmic Therapy in Comorbid Elderly and Senile Patients with Paroxysmal and Recurrent Atrial Fibrillation

Abstract

Aim. Comparison of different treatment tactics – medicated antiarrhythmic therapy (AAT) and radiofrequency ablation (RFA) of elderly and senile pa- tients with relapsing atrial fibrillation (AF) as more severe patients with a burdened comorbid background.Material and methods. The study included 108 patients with paroxysmal and persistent AF who were in hospital and then under outpatient observation for 2 years. Depending on the method of treatment, patients were divided into 2 groups: the group receiving medicated AAT (n=45) and the group treated with RFA (63 patients). Most patients of the 2nd group (n=60) after the RFA received AAT, i.e. so-called hybrid therapy. These groups were comparable in age (mean age 64.9 and 64.7 years, respectively), sex and underlying pathology, comorbid diseases.Results. In patients who received "hybrid" therapy after 2 years of observation, it was more often possible to preserve the sinus rhythm and achieve a reduction in arrhythmia episodes in comparison with the drug group (95.2% and 86.6%, respectively). Quality of life and the frequency of complications of AAT in these groups of patients were comparable.Conclusion: In elderly and senile patients with paroxysmal and persistent atrial fibrillation, RFA and hybrid therapy was more effective for maintaining sinus rhythm compared to drug therapy. After RFA in this category of patients, in most cases, medicated AAT was used. When choosing the tactics of rational AAT in elderly patients, preference should be given to tactics in which it is possible to achieve an improvement in the quality of life.

Keywords

• atrial fibrillation
• comorbidity
• antiarrhythmic therapy
• radiofrequency ablation
• elderly age