As elderly patients present significant challenges for long-term pharmacologic management, nonpharmacologic treatment of atrial fibrillation (AF) will continue to be a vital option in improving the quality of life and function of these patients. This review discusses nonpharmacologic approaches for AF in the elderly. Observational studies of catheter ablation suggest similar long-term efficacy and safety rates in elderly and younger groups. Minimally invasive surgical approaches have distinct advantages in certain populations. Further research, adequately powered to assess age-related differences, is needed to confirm the findings of observational studies of elderly patients who have undergone nonpharmacologic approaches to rhythm control.
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