Rate-control vs rhythm-control of atrial fibrillation in elderly patients. From new, age-oriented outcomes to a more complex management strategy

Submitted: April 24, 2018
Accepted: May 11, 2018
Published: June 7, 2018
Abstract Views: 3500
PDF: 841
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


Atrial fibrillation (AF) is the most frequent arrhythmia in elderly people. Findings derived from clinical trials seem to demonstrate that a rate-control strategy of AF in aged patients improves prognosis if compared to a rhythm-control one. However, epidemiological studies concordantly show that the arrhythmia is associated to increased hospitalization and mortality rates. In last years, the proportion of patients admitted to hospital for AF has progressively increased; this trend is observed in subjects >75 and >85 years, while no change was found in younger cohorts. Importantly, in aged individuals, probably because of the loss of atrial activity, the increase of heart rate and the irregularity of RR intervals, AF begins a vicious cycle, leading from heart failure, through the compromise of functional and neurocognitive status, to overt disability, dementia and increased mortality. Evidence specifically aimed at clarifying the effects of arrhythmia management on outcomes characteristic of aged people is completely lacking. In the elderly, the question regarding the effects of a rate- or a rhythm-control strategy of AF should be considered as an aspect of a more complex strategy, addressed to reduce disability and hospitalizations, and to improve quality of life and survival.



PlumX Metrics


Download data is not yet available.


How to Cite

Fumagalli, Stefano, Serena Boni, Simone Pupo, Marta Migliorini, Irene Marozzi, Eleonora Barghini, Flavia Sacco, and Niccolò Marchionni. 2018. “Rate-Control Vs Rhythm-Control of Atrial Fibrillation in Elderly Patients. From New, Age-Oriented Outcomes to a More Complex Management Strategy”. Monaldi Archives for Chest Disease 88 (2). https://doi.org/10.4081/monaldi.2018.955.