Stefano Bianchi

Chief of Arrhythmias Unit Ospedale Fatebenefratelli Isola Tiberina Rome, Italy Management of atrial fibrillation in the rapidly growing population of older patients involves a comprehensive strategy that includes consideration of their co-morbidities, functional and social status. Activity level and medication tolerance are different in this category of patients and expectations are focused on quality of life and symptom relief. Invasive methods, such as catheter ablation, are the new frontier of treatment for maintaining sinus rhythm in this population with complication rate comparable to younger patients. References: 1. Cappato R, Calkins H, Chen SA, Davies W, Iesaka Y, Kalman J, Kim YH, Klein G, Natale A, Packer D, Skanes A, Ambrogi F, Biganzoli E. Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3:32. 2. Metzner I, Wissner E, Tilz RR, Rillig A, Mathew S, Schmidt B, Chun J, Wohlmuth P, Deiss S, Lemes C, Maurer T, Fink T, Heeger C, Ouyang F, Kuck KH, Metzner A. Ablation of atrial fibrillation in patients ≥75 years: longterm clinical outcome and safety. Europace. 2016;18:543-9. 3. Olshansky B, Rosenfeld LE, Warner AL, Solomon AJ, O'Neill G, Sharma A, Platia E, Feld GK, Akiyama T, Brodsky MA, Greene HL; AFFIRM Investigators. The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study: approaches to control rate in atrial fibrillation. J Am Coll Cardiol. 2004;43:1201-8.