Clinical Analysis Of227Cases Of Elderly Patients With Atrial Fibrillation

Objective:To investigate the gender, age distribution, and the epidemiology of causes of elderly patients with atrial fibrillation (AF) of the first affiliated hospital of guangxi medical university. To investigate the conditions of anti-thromboembolism treatment, antiarrhythmic treatment of the elderly patients with AF in order to provide a reference for future clinical treatment of elderly patients with AF.Methods:Clinical features of227elderly patients with AF from January2013to December2013in the first affiliated hospital of guangxi medical university were analyzed retrospectively.Result:1、In227cases elderly patients with AF,48.9%were male and51.1%were female. Classification of age, the number of elderly patients with AF cases decreased with the increasing of age. The young elderly patients with AF in 60-74years-old accounted for the largest percent. Classification of gender, there were more male than female in the60-74year-old group, and female were more than male in75-89year-old group and≥90year-old group.2、In227cases of elderly patients with AF, the proportion of valvular AF was23.8%, and non-valvular AF was76.2%. The proportion of female in valvular AF was significantly higher than the non-valvular AF (P<0.05). The average age of valvular AF was younger than the non-valvular AF (P<0.05). The LAD of valvular AF was larger than the non-valvular AF (P<0.05).3、In the uni-factor analysis of227cases of elderly patients with AF, the top five causes followed by heart failure(72.1%), hypertension(53.3%), CHD(39.6%), diabetes(23.3%), and RHD(18.1%).4、Classification of gender, in CHD elderly patients with AF, male were more than female(p<0.05), in heart failure elderly patients with AF, female were more than male(p<0.05), in lone atrial fibrillation elderly patients with AF, male were more than female(p<0.05), in RHD elderly patients with AF, female were more than male(p<0.05), in pulmonary heart disease elderly patients with AF, male were more than female(p<0.05).5、In the antithrombotic therapy of227cases elderly patients with AF, the proportion of antithrombotic therapy was89%in all patients. Aspirin accounted for35.7%, clopidogrel accounted for3.1%, and aspirin+clopidogrel accounted for25.1%. The proportion of the patients treated with warfarin was27.3%of all patients, other anticoagulants accounted for18.9%. The proportion of using warfarin in valvular AF was higher than it in non-valvular AF (P<0.05). The compliance rate of the antithrombotic therapy of227cases elderly patients with AF was31.3%. The compliance rate of the antithrombotic therapy of227cases elderly patients with AF decreased with the increasing of CHA2DS2-VASc score and age.6、In the treatment of antiarrhythmic227cases elderly patients with AF, the proportion of antiarrhythmic therapy was84.6%in all patients, the proportion of drug cardioversion (rhythm control) was10.6%, the proportion of rate control was74.0%. The proportion of the top three antiarrhythmic treatment followed by133cases of beta-blockers(58.6%),99cases of digitalis(43.6%) and24cases of cardioversion(10.6%).Conclusion:1、The number of elderly patients with AF cases decreased with the increasing of age. The young elderly patients with AF in60-74years-old accounted for the largest percent. Classification of gender, there were more male than female in the60-74year-old group, and female were more than male in75-89year-old group and≥90year-old group.2、The top five risk factor of221elderly patients with AF were heart failure, hypertension, CHD, diabetes, RHD. It was similar to most of the epidemiological investigation of domestically and internationally.3、Classification of gender, there were more male than female in CHD, pulmonary heart disease, lone atrial fibrillation,female were more than male in heart failure, RHD.4、The antiplatelet-therapy was the major treatment to the prevention of thromboembolism in this study. The anticoagulant therapy there is obviously insufficient. The compliance rate of the antithrombotic therapy of227cases elderly patients with AF decreased with the increasing of CHA2DS2-VASc score and age。5、In the respect of antiarrhythmic-therapy, the proportion of rate control was higher than it in rhythm control.