Antiarrhythmic Drugs in Atrial Fibrillation: Is There Still a Role for Rhythm Control?

Association between atrial fibrillation, frailty, and geriatric syndromes in the late elderly in a south Belgian outpatient and inpatient setting

Study objective

This study aims to analyze the relationship between AF, frailty, and geriatric syndromes in elderly patients in an outpatient and inpatient setting in a South Belgian hospital.

Participants design and setting

This is a single center case-control retrospective study including 207 patients enrolled from an outpatient and inpatient setting of the Department of Geriatrics, Jolimont Hospital Group. Frailty was assessed using a complete geriatric assessment and Rockwoods Clinical Frailty Scale.

Results

AF was strongly associated with age, cardiovascular history, congestive heart failure, as well as with multiple geriatric syndromes such as vascular dementia, malnutrition, functional decline in Activities of Daily Living, mobility impairment and chronic ulcerous disease. Furthermore, there was a tight relationship between AF and Rockwoods' frailty phenotypes. This association was maintained throughout multivariable modelling including age (OR 1.06, IC 1.03-1.14, p = 0.042), sex (OR 2.30, IC 1.11-4.84, p = 0.026), congestive heart failure (OR 3.70, IC 1.77-7.91, p < 0.001) and a CFS more than 4 (OR 2.68, IC 1.18-6.43, p = 0.021).

Conclusion

A deeper understanding of associations between atrial fibrillation and geriatric syndromes and frailty could give new patient management perspectives beyond pharmaceutical or interventional treatment.