Atrial Fibrillation in Older Adults

Medically Reviewed by James Beckerman, MD, FACC on July 08, 2022
Written by Alexandra Benisek
4 min read

Atrial fibrillation (AFib) is the most common type of abnormal heart rhythm condition in older adults. And your risk of AFib goes up as you age. Experts continue to create better treatment options for AFib in older adults.

You can get AFib at any age. But simply being older raises your chances for AFib. At the same time, older people are more likely to have other conditions that raise your risk of AFib. These include:

  • High blood pressure
  • Coronary artery disease
  • Heart valve problems
  • Heart failure

AFib and age each raise your risk of a stroke. That means that if you are an older adult and have AFib, your chances of stroke are much higher. One study found that nearly 8 out of 100 women aged 70 who had AFib had a stroke within 5 years. That compares to about 3 of 100 women of the same age who did not have AFib. The same study stated that about 7 in 100 men aged 70 with AFib had a stroke within 5 years. Five in 100 men of the same age without AFib had a stroke.

As you age, you can take control of certain factors that might put you at risk for AFib. These include:

Body massindex (BMI). Obesity plays a large role in the development of AFib. If you have a higher BMI, you’ll be at a higher risk for AFib. Higher body weight in people with AFib also means the condition is more likely to progress. It’s important to keep a healthy BMI, especially as you get older.

Diabetes. Type 2 diabetes can develop at any age, but it’s more common in middle-aged and older adults. If you have type 2 diabetes, your risk of AFib is much higher than those without the condition. Because of this, it’s important that you lower your risk for type two diabetes.

You can lower your risk of type two diabetes if you:

  • Lose extra weight
  • Get more exercise
  • Eat healthy fats and focus on a plant-based diet
  • Stay away from fad diets and focus on balanced nutrition

Obstructive sleep apnea (OSA). You’re more likely to develop OSA as you age. Experts have found that OSA is a risk factor for stroke and may put you at a higher risk for AFib.

You may not have any symptoms at all with AFib. When this happens in older people, it could be because AFib symptoms tend to lessen or go away during longer periods of irregular heartbeats. Your doctor may instead find your AFib during a routine doctor visit. While they do your checkup, they might notice you have an irregular heart rhythm.

You might notice other symptoms of AFib such as:

  • Tiredness or sluggishness, which you might mistake as a symptom of aging
  • Less of an ability to work out
  • Heart palpitations, pounding, or fluttering
  • An irregular or fast heartbeat
  • Breathlessness
  • Feeling lightheaded or faint
  • Chest pains
  • Cough
  • Fainting

There are a few ways to treat AFib. The first goal of AFib treatment is to prevent issues related to blood clots, like strokes. Your doctor will do this through anticoagulant therapy, or therapies that prevent blood clots. If your doctor can control this risk, you’re more likely to live longer.

Next, they’ll want to provide you with a better quality of life through treatment. Your doctor will aim to lower your symptoms and hospital visits. To do so, you’ll use rhythm or rate control therapies.

Some treatments for AFib include:

Anticoagulation therapy. Experts suggest that older people with AFib take treatments to prevent blood clots. But it’s important that your doctor monitors you while on these treatments. Sometimes they can heighten your risk of bleeding.

Percutaneous left atrial appendage closure. If you can’t tolerate or don’t want anticoagulation therapy, you can get this procedure instead. This surgery will close off your left atrial appendage and control your stroke risk alongside other AFib risks.

Antiarrhythmic drugs. These forms of treatment will control your heart rate. Antiarrhythmic drugs are especially helpful in older adults who have AFib without symptoms.

Rhythm control treatments could be helpful. But they can also lead to serious side effects in elderly people with AFib.

Catheter ablation. This treatment can help maintain a regular heartbeat if you have AFib. But it might be dangerous if you’re older. The good news is, experts continue to work on improved ablation methods that may help older adults with AFib.

Men between the ages 55-74 with AFib have a 61.5% death rate within 10 years of diagnosis. This is compared to a 30% rate in men who don’t have the condition. Women of the same age with AFib had a 10-year death rate of 57.6% versus 20.9% in women without AFib.

You can still live a long and healthy life with the condition. See your doctor regularly, even if you don’t have any symptoms. They’ll be able to check you for both AFib and other conditions that affect it.

Experts continue to look into the ties among aging, AFib, and other age-related diseases. Through this, they’ll be able to create and improve on AFib prevention and treatment therapies.

Before, AFib research didn’t focus on treatment options for older people. But now, experts have shifted their attention to find effective treatments that consider older people’s specific needs.