{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T04:17:32Z","timestamp":1743826652318,"version":"3.40.3"},"reference-count":28,"publisher":"SLACK, Inc.","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Gerontol Nurs"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:p>Atrial fibrillation is the most common arrhythmia among older adults. Valvular heart disease, dilated cardiomyopathy, aortic stenosis, hypertension, coronary artery disease, pericarditis, thyrotoxicosis, pulmonary disease, cardiac surgery, alcohol excess, and alcohol withdrawal are associated with atrial fibrillation. Nurses caring for older adults need to understand the condition's pathophysiology, signs and symptoms, diagnostic data and treatment protocols, and adherence issues to prevent the formation of emboli in chronic atrial fibrillation and to understand treatment of this common arrhythmia. This article presents an individual example of an elderly man exhibiting a new onset of atrial fibrillation and the interventions required to manage the associated complications. Atrial fibrillation places patients at risk for stroke from a thromboembolism; thus, pharmacological and nonpharmocological care strategies for managing patients with atrial fibrillation are discussed.<\/jats:p>","DOI":"10.3928\/00989134-20080701-04","type":"journal-article","created":{"date-parts":[[2009,3,16]],"date-time":"2009-03-16T17:33:36Z","timestamp":1237224816000},"page":"26-33","source":"Crossref","is-referenced-by-count":8,"title":["Atrial Fibrillation Among Older Adults: Pathophysiology, Symptoms, and Treatment"],"prefix":"10.3928","volume":"34","author":[{"given":"Sonya R.","family":"Hardin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Steele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_2_2_1","first-page":"130","article-title":"Indications for anticoagulation in atrial fibrillation","volume":"58","author":"Akhtar W.","year":"1998","unstructured":"Akhtar, W., Reeves, W., & Movahed, A. (1998). Indications for anticoagulation in atrial fibrillation. American Family Physician, 58, 130\u2013136.","journal-title":"American Family Physician"},{"key":"e_1_3_2_3_1","author":"American Heart Association","year":"1996","unstructured":"American Heart Association. (1996). Management of patients with atrial fibrillation. Retrieved January 10, 2008, from http:\/\/www.americanheart.org\/presenter.jhtml?identifier=1507","journal-title":"Management of patients with atrial fibrillation"},{"key":"e_1_3_2_4_1","first-page":"43","article-title":"Cardiogenic embolism as the main cause of ischemic stroke in a city hospital: An interdisciplinary study","volume":"30","author":"Becker E.I.","year":"2001","unstructured":"Becker, E.I., Jung, A., V\u00f6ller, H., Wegscheider, K., Vogel, H.P., & Landgraf, H. (2001). Cardiogenic embolism as the main cause of ischemic stroke in a city hospital: An interdisciplinary study. VASA, 30, 43\u201352.","journal-title":"VASA"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/00044067-200102000-00014","article-title":"Atrial fibrillation: Treatment rationale and clinical utility of nonpharmacologic therapies","volume":"12","author":"Bubien R.S.","year":"2001","unstructured":"Bubien, R.S., & Sanchez, J.E. (2001). Atrial fibrillation: Treatment rationale and clinical utility of nonpharmacologic therapies. AACN Clinical Issues, 12, 140\u2013155.","journal-title":"AACN Clinical Issues"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S1036-7314(04)80005-5","article-title":"Non-valvular atrial fibrillation and stroke: Implications for nursing practice and therapeutics","volume":"17","author":"Davidson P.","year":"2004","unstructured":"Davidson, P., Rees, D.M., Brighton, T.A., Enis, J., McCrohon, J., Elliott, D., . (2004). Non-valvular atrial fibrillation and stroke: Implications for nursing practice and therapeutics. Australian Critical Care, 17, 65\u201373.","journal-title":"Australian Critical Care"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1001\/archinte.165.3.258","article-title":"Rate vs rhythm control in patients with atrial fibrillation: A meta-analysis","volume":"165","author":"de Denus S.","year":"2005","unstructured":"de Denus, S., Sanoski, C.A., Carlsson, J., Opolski, G., & Spinler, S.A. (2005). Rate vs rhythm control in patients with atrial fibrillation: A meta-analysis. Archives of Internal Medicine, 165, 258\u2013262.","journal-title":"Archives of Internal Medicine"},{"key":"e_1_3_2_8_1","first-page":"e257","article-title":"ACC\/AHA\/ESC 2006 guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society","volume":"114","author":"Fuster V.","year":"2006","unstructured":"Fuster, V., Ryd\u00e9n, L.E., Cannom, D.S., Crijns, H.J., Curtis, A.B., Ellenbogen, K.A., . (2006). ACC\/AHA\/ESC 2006 guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation, 114, e257\u2013e354.","journal-title":"Circulation"},{"key":"e_1_3_2_9_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S0001-2092(06)61101-0","article-title":"The maze III surgical procedure","volume":"76","author":"Green B.","year":"2002","unstructured":"Green, B. (2002). The maze III surgical procedure. AORN Journal, 76, 134\u2013146.","journal-title":"AORN Journal"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1177\/0193945904265815","article-title":"Uncertainty and its antecedents in patients with atrial fibrillation","volume":"26","author":"Kang Y.","year":"2004","unstructured":"Kang, Y., Daly, B.J., & Kim, J.S. (2004). Uncertainty and its antecedents in patients with atrial fibrillation. Western Journal of Nursing Research, 26, 770\u2013783.","journal-title":"Western Journal of Nursing Research"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/00005082-200403000-00007","article-title":"Implications for nursing care of patients with atrial fibrillation: Lessons learned from the AFFIRM and RACE studies","volume":"19","author":"Kellen J.C.","year":"2004","unstructured":"Kellen, J.C. (2004). Implications for nursing care of patients with atrial fibrillation: Lessons learned from the AFFIRM and RACE studies. Journal of Cardiovascular Nursing, 19, 128\u2013137.","journal-title":"Journal of Cardiovascular Nursing"},{"issue":"8","key":"e_1_3_2_12_1","first-page":"S78","article-title":"Epidemiology and classification of atrial fibrillation","volume":"9","author":"L\u00e9vy S.","year":"1998","unstructured":"L\u00e9vy, S. (1998). Epidemiology and classification of atrial fibrillation. Journal of Cardiovascular Electrophysiology, 9(8 Suppl.), S78\u2013S82.","journal-title":"Journal of Cardiovascular Electrophysiology"},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/00001573-200001000-00007","article-title":"Classification system of atrial fibrillation","volume":"15","author":"L\u00e9vy S.","year":"2000","unstructured":"L\u00e9vy, S. (2000). Classification system of atrial fibrillation. Current Opinion in Cardiology, 15, 54\u201357.","journal-title":"Current Opinion in Cardiology"},{"key":"e_1_3_2_14_1","doi-asserted-by":"crossref","first-page":"2608","DOI":"10.1161\/hc4601.099402","article-title":"Effects of angiotension-converting enzyme inhibition on the development of the atrial fibrillation substrate in dogs with ventricular tachypacing-induced congestive heart failure","volume":"104","author":"Li D.","year":"2001","unstructured":"Li, D., Shinagawa, K., Pang, L., Leung, T.K., Cardin, S., Wang, Z., . (2001). Effects of angiotension-converting enzyme inhibition on the development of the atrial fibrillation substrate in dogs with ventricular tachypacing-induced congestive heart failure. Circulation, 104, 2608\u20132614.","journal-title":"Circulation"},{"issue":"9","key":"e_1_3_2_15_1","first-page":"12","article-title":"Anticipating drug response. A commonly used anticoagulant has many drug-drug interactions","volume":"98","author":"Lilley L.L.","year":"1998","unstructured":"Lilley, L.L., & Guanci, R. (1998). Anticipating drug response. A commonly used anticoagulant has many drug-drug interactions. American Journal of Nursing, 98(9), 12.","journal-title":"American Journal of Nursing"},{"key":"e_1_3_2_16_1","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/j.0889-7204.2002.01450.x","article-title":"Atrial fibrillation: The newest frontier in arrhythmia management","volume":"17","author":"McCabe P.J.","year":"2002","unstructured":"McCabe, P.J., & Geoffroy, S. (2002). Atrial fibrillation: The newest frontier in arrhythmia management. Progress in Cardiovascular Nursing, 17, 110\u2013123.","journal-title":"Progress in Cardiovascular Nursing"},{"key":"e_1_3_2_17_1","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1161\/01.CIR.100.4.376","article-title":"Trandolapril reduces the incidence of atrial fibrillation after acute myocardial infarction in patients with left ventricular dysfunction","volume":"100","author":"Pedersen O.D.","year":"1999","unstructured":"Pedersen, O.D., Bagger, H., Kober, L., & Torp-Pedersen, C. (1999). Trandolapril reduces the incidence of atrial fibrillation after acute myocardial infarction in patients with left ventricular dysfunction. Circulation, 100, 376\u2013380.","journal-title":"Circulation"},{"key":"e_1_3_2_18_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/00005082-200501000-00010","article-title":"Satisfaction with treatment and prevalence of discomfort after external electrical cardioversion","volume":"20","author":"Pita-Fern\u00e1ndez S.","year":"2005","unstructured":"Pita-Fern\u00e1ndez, S., Fari\u00f1as-Garrido, M.P., Su\u00e1rez-Fontai\u00f1a, E.M., Amor-Camb\u00f3n, J., S\u00e1nchez-Su\u00e1rez, I., R\u00faa-P\u00e9rez, M.C., . (2005). Satisfaction with treatment and prevalence of discomfort after external electrical cardioversion. Journal of Cardiovascular Nursing, 20, 49\u201355.","journal-title":"Journal of Cardiovascular Nursing"},{"key":"e_1_3_2_19_1","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1053\/gn.1999.v20.101045001","article-title":"Atrial fibrillation in the older adult: Presentation and management issues","volume":"20","author":"Resnick B.","year":"1999","unstructured":"Resnick, B. (1999). Atrial fibrillation in the older adult: Presentation and management issues. Geriatric Nursing, 20, 188\u2013193.","journal-title":"Geriatric Nursing"},{"key":"e_1_3_2_20_1","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1097\/00044067-200111000-00018","article-title":"Evidence-based practice centers: Production of evidence report on management of atrial fibrillation","volume":"12","author":"Robinson K.A.","year":"2001","unstructured":"Robinson, K.A., McNamara, R.L., Bass, E.B., & Powe, N.R. (2001). Evidence-based practice centers: Production of evidence report on management of atrial fibrillation. AACN Clinical Issues, 12, 618\u2013627.","journal-title":"AACN Clinical Issues"},{"key":"e_1_3_2_21_1","author":"Rosenthal L.","year":"2007","unstructured":"Rosenthal, L. (2007). Atrial fibrillation. Retrieved April 14, 2007, from the eMedicine Web site: http:\/\/www.emedicine.com\/MED\/topic184.htm","journal-title":"Atrial fibrillation"},{"issue":"3","key":"e_1_3_2_22_1","doi-asserted-by":"crossref","first-page":"429S","DOI":"10.1378\/chest.126.3_suppl.429S","article-title":"Antithrombotic therapy in atrial fibrillation","volume":"126","author":"Singer D.E.","year":"2004","unstructured":"Singer, D.E., Albers, G.W., Dalen, J.E., Go, A.S., Halperin, J.L., & Manning, W.J. (2004). Antithrombotic therapy in atrial fibrillation. Chest, 126(3 Suppl.), 429S\u2013456S.","journal-title":"Chest"},{"key":"e_1_3_2_23_1","first-page":"115","article-title":"Atrial fibrillation in the 21st century: The new cardiac \u201cCinderella\u201d and new horizons for cardiovascular nursing?","volume":"1","author":"Stewart S.","year":"2002","unstructured":"Stewart, S. (2002). Atrial fibrillation in the 21st century: The new cardiac \u201cCinderella\u201d and new horizons for cardiovascular nursing? European Journal of Cardiovascular Nursing, 1, 115\u2013121.","journal-title":"European Journal of Cardiovascular Nursing"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-2018.2003.00136.x"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)91639-0"},{"key":"e_1_3_2_26_1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1097\/00003465-200411000-00005","article-title":"Radiofrequency ablation in the pulmonary veins for paroxysmal, drug-resistant atrial fibrillation","volume":"23","author":"Thompson E.J.","year":"2004","unstructured":"Thompson, E.J., Reich, D.A., & Meadows, J.L. (2004). Radiofrequency ablation in the pulmonary veins for paroxysmal, drug-resistant atrial fibrillation. Dimensions of Critical Care Nursing, 23, 255\u2013263.","journal-title":"Dimensions of Critical Care Nursing"},{"key":"e_1_3_2_27_1","author":"U.S. Preventive Services Task Force","year":"2000","unstructured":"U.S. Preventive Services Task Force. (2000\u20132003). U.S. Preventive Services Task Force ratings: Strength of recommendations and quality of evidence. Retrieved June 11, 2008, from the Agency for Healthcare Research and Quality Web site: http:\/\/www.ahrq.gov\/clinic\/3rduspstf\/ratings.htm","journal-title":"U.S. Preventive Services Task Force ratings: Strength of recommendations and quality of evidence"},{"key":"e_1_3_2_28_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00109-004-0589-1","article-title":"Meta-analysis of clinical characteristics of 299 carriers of LMNA gene mutations: Do lamin A\/C mutations portend a high risk of sudden death?","volume":"83","author":"van Berlo J.H.","year":"2005","unstructured":"van Berlo, J.H., de Voogt, W.G., van der Kooi, A.J., van Tintelen, J.P., Bonne, G., Yaou, R.B., . (2005). Meta-analysis of clinical characteristics of 299 carriers of LMNA gene mutations: Do lamin A\/C mutations portend a high risk of sudden death? Journal of Molecular Medicine, 83, 79\u201383.","journal-title":"Journal of Molecular Medicine"},{"key":"e_1_3_2_29_1","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/0002-9149(85)91186-5","article-title":"Effect of enalapril on ventricular arrhythmias in congestive heart failure","volume":"56","author":"Webster M.W.","year":"1985","unstructured":"Webster, M.W., Fitzpatrick, M.A., Nicholls, M.G., Ikram, H., & Wells, J.E. (1985). Effect of enalapril on ventricular arrhythmias in congestive heart failure. American Journal of Cardiology, 56, 566\u2013569.","journal-title":"American Journal of Cardiology"}],"container-title":["Journal of Gerontological Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.healio.com\/doiresolver?doi=10.3928\/00989134-20080701-04","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T15:57:28Z","timestamp":1743782248000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/00989134-20080701-04"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7]]},"references-count":28,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2008,7]]}},"alternative-id":["10.3928\/00989134-20080701-04"],"URL":"https:\/\/doi.org\/10.3928\/00989134-20080701-04","relation":{},"ISSN":["0098-9134","1938-243X"],"issn-type":[{"type":"print","value":"0098-9134"},{"type":"electronic","value":"1938-243X"}],"subject":[],"published":{"date-parts":[[2008,7]]}}}