Atrial fibrillation and its geriatric aspects: news of the last 5 years (review)
Background: The prevalence of atrial fibrillation in the modern world is constantly increasing. In most cases, this pathology occurs in elderly and senile people that makes it an important geriatric problem. Despite a large number of studies, there are many unresolved issues concerning pathogenesis and treatment of atrial fibrillation. The aim of the study: Analysis of current literature data about the etiology, pathogenesis, diagnosis and management of atrial fibrillation. Materials and methods: The scientific papers that were published in the open access in the databases of PubMed, Embase, Web of Science, Elibrary and Google Scholar were analyzed. Scientific articles that were mainly published in English since January 1, 2017 were chosen for further analysis. Their references to previously published works were considered. Literature sources were searched by the following keywords: atrial fibrillation, direct oral anticoagulants, catheter ablation, and genetics. In analyzing the literature, special attention was paid to systematic reviews and meta-analyses of research findings. Results: The review presents current data on the influence of inflammation and the state of the autonomic nervous system on the development of atrial fibrillation; much attention is paid to the role of genetic factors in its development. Attention is paid to the peculiarities of medication in the elderly. Attention is paid to the peculiarities of drug therapy in the elderly. The efficacy of various approaches to the treatment of atrial fibrillation is compared and attention is drawn to the possible prospects for further research in this field. Conclusion: The existing medication and surgical methods of atrial fibrillation treatment do not always achieve the desired results. The mortality rate of such patients remains high not only from complications of the natural course of the disease (thromboembolism), but also from complications of the ongoing treatment (hemorrhage). Despite significant progress in the study of atrial fibrillation, there is a need for additional research into the molecular mechanisms of this pathology, as well as the search for more effective and safe ways of anticoagulant and antiarrhythmic therapy.
Bunova SS, Timakova AYu, Skirdenko YuP, et al. Atrial fibrillation and its geriatric aspects: news of the last 5 years (review). Research Results in Biomedicine. 2023;9(1):86-101. Russian. DOI: 10.18413/2658-6533-2023-9-1-0-6
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