Ageing and atrial change

AF becomes more common with age. This is not simply “wear and tear,” but reflects gradual changes in heart tissue, cumulative exposure to blood pressure and metabolic stress, and a higher chance of structural heart changes.

What changes with age

• Small areas of fibrosis (stiffening) can develop in atrial tissue.
• The atria may enlarge slightly over time, especially with hypertension or a stiff heart.
• The balance of the nervous system that controls heart rate changes.

What this means for patients

Age-related risk does not mean AF cannot be improved. Many older patients reduce AF burden by addressing modifiable contributors: blood pressure, sleep apnea, weight trajectory, alcohol, and treatment of other heart conditions.