Fibrilación atrial en los adultos mayores

Autores/as

  • Jorge Brizuela Torres Caja Costarricense de Seguro Social
  • Fernando Morales Martínez Caja Costarricense de Seguro Social

DOI:

https://doi.org/10.51481/amc.v51i3.439

Palabras clave:

fibrilación atrial, adulto mayor, anticoagulación, prevención, antiplaquetarios, accidente cerebrovascular

Resumen

La fibrilación atrial es la taquiarritmia más prevalente en los adultos mayores. La frecuencia de dicha arritmia aumenta con la edad, presentándose en un 1.5% de los 50 a 59 años a 10% de los 80 a 89 años. La fibrilación atrial no valvular incrementa el riesgo de sufrir un evento cerebrovascular isquémico cardioembólico en 5 veces y causa el 15% de todos los accidentes cerebrovasculares isquémicos en Estados Unidos de América. El manejo de la fibrilación atrial se enfoca, principalmente, en la prevención de los fenómenos tromboembólicos y en el control de la frecuencia y ritmo cardiaco. La anticoagulación, cuando está indicada, ha demostrado ser la principal herramienta en la prevención de dichos eventos. Sin embargo, aunque las complicaciones hemorrágicas son más frecuentes, en esta población, y aumentan con la edad, sobrepasa por mucho, el beneficio al riesgo. El control de la frecuencia cardiaca ha demostrado ser igual o mejor que el control del ritmo en cuanto a prevención de eventos cerebrovasculares y mortalidad en estos pacientes. La edad cronológica por sí sola, no es contraindicación alguna para ofrecer una terapia óptima. Debe tomarse en cuenta el estado funcional, cognitivo y social, así como aspectos fisiológicos del envejecimiento con respecto a la prescripción de medicamentos. Cuando, a pesar del tratamiento adecuado, la sintomatología persiste, las estrategias invasivas han demostrado ser beneficiosas, pero faltan estudios que involucren a individuos mayores.

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Citas

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Publicado

2009-06-17

Cómo citar

Brizuela Torres, J., & Morales Martínez, F. (2009). Fibrilación atrial en los adultos mayores. Acta Médica Costarricense, 51(3), 138–146. https://doi.org/10.51481/amc.v51i3.439