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İleri Yaş Atriyal Fibrilasyonlu Hastalarda Yaşa Bağlı Değişiklikler

Yıl 2026, Cilt: 10 Sayı: 1 , 1 - 10 , 30.04.2026
https://doi.org/10.33716/bmedj.1857891
https://izlik.org/JA53XM43AP

Öz

Amaç: Atriyal fibrilasyon (AF), dünya çapında en sık karşılaşılan kardiyak aritmidir. Yaşla birlikte görülme sıklığı önemli ölçüde artmaktadır. Buna rağmen, yaşlı hastalar klinik çalışmalarda yeterince temsil edilmemekte ve bu gruba optimal medikal tedavi daha seyrek verilmektedir. Bu çalışmanın amacı, AF’si olan yaşlı hastalarda yaşa bağlı değişiklikleri değişiklikleri saptamaktır. Gereç ve Yöntem: 75 yaş ve üzeri (orta yaşlılar) kalıcı atriyal fibrilasyonu olan 118 hasta ile 65-75 yaş arası (genç yaşlılar) kalıcı atriyal fibrilasyonu olan 153 hasta retrospektif olarak değerlendirildi. Gruplar arasındaki demografik, biyokimyasal ve ekokardiyografik parametreler karşılaştırıldı. Bulgular: 75 yaş ve üzeri atriyal fibrilasyonlu hastalarda 85 (%72) hipertansiyon, 43 (%36) diyabet mellitus ve 56 (%48) koroner arter hastası vardı. 65-75 yaş arası atriyal fibrilasyonlu hastalarda ise 91 (%60) hipertansiyon, 43 (%28) diyabet mellitus ve 60 (%39) koroner arter hastası vardı. 75 yaş ve üzeri hastalarda, 65-75 yaş arası hastalara kıyasla daha fazla sayıda hipertansiyon, diyabet mellitus ve koroner arter hastalığı vardı (sırasıyla p=0.021, p=0.092, p=0.108). Ancak istatistiksel olarak anlamlılık düzeyine yalnızca hipertansiyon ulaştı. Ayrıca 75 yaş ve üzeri hastalarda kreatinin [1,15±0,36 mg/dl'ye karşı 1,03±0,23 mg/dl, p=0,003] ve üre [53,4±29,8 mg/dl'ye karşı 41,4±15,5 mg/dl, p<0,001] düzeyleri daha yüksek iken; eGFR [54,9±14,8 ml/dk vs 69,5±17,7 ml/dk, p<0,001], hemoglobin (11,5±2,1 g/dl vs 12,9±1,8 g/dl, p<0,001) ve albümin [3,67±0,54 g/dl vs 4±0,44 g/dl, p=0,003] düzeyleri daha düşük saptandı. Sonuç: AF'li hastalarda yaş ilerledikçe, başta hipertansiyon ve kronik böbrek hastalığı olmak üzere eşlik eden hastalıklar artmaktadır. Bu hastalarda AF tedavisini optimize etmek yanında, aynı zamanda eşlik eden hastalıkları da yönetmek önemlidir.

Etik Beyan

Bu retrospektif çalışma, Helsinki Bildirgesi'ne uygun olarak Balıkesir Üniversitesi Klinik Araştırma Etik Kurulu tarafından onaylanmıştır (Karar no: 2023/137; Tarih: 11.10.2023).

Destekleyen Kurum

Yok

Teşekkür

Yok

Kaynakça

  • Chugh, S. S., Havmoeller, R., Narayanan, K., Singh, D., Rienstra, M., Benjamin, E. J., Gillum, R. F., Kim, Y. H., McAnulty, J. H., Jr, Zheng, Z. J., Forouzanfar, M. H., Naghavi, M., Mensah, G. A., Ezzati, M., & Murray, C. J. (2014). Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation, 129(8), 837–847. https://doi.org/10.1161/CIRCULATIONAHA.113.005119
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Age-Related Differences in Elderly Patients with Atrial Fibrillation

Yıl 2026, Cilt: 10 Sayı: 1 , 1 - 10 , 30.04.2026
https://doi.org/10.33716/bmedj.1857891
https://izlik.org/JA53XM43AP

Öz

Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide. Its prevalence increases significantly with age. Therefore, it is particularly important in the elderly population. Despite this, elderly patients have been underrepresented in clinical studies, and optimal medical treatment is less frequently provided to this group. The aim of this study is to identify age-related patterns in elderly patients and to evaluate their relationships with comorbidities. Materials and Methods: 118 patients with permanent AF aged ≥75 years (middle-old) and 153 patients with permanent AF aged 65-75 years (youngest-old) were retrospectively evaluated. Demographic, biochemical and echocardiographic parameters were compared between groups. Results: There were 85 cases (72%) of hypertension, 43 cases (36%) of diabetes mellitus, 56 cases (48%) of coronary artery disease in patients with AF aged ≥75 years. There were 91 cases (60%) of hypertension, 43 cases (28%) of diabetes mellitus, 60 cases (39%) of coronary artery disease in patients with AF aged 65-75 years. Patients with AF aged ≥75 years had more hypertension, diabetes mellitus and coronary artery disease compared to the patients with AF aged 65-75 years (p=0.021, p=0.092, p=0.108, respectively). However, only hypertension reached statistical significance. Also, creatinine [1.15±0.36 mg/dl vs 1.03±0.23 mg/dl, p=0.003], urea [53.4±29.8 mg/dl vs 41.4±15.5 mg/dl, p<0.001] levels were higher; while eGFR [54.9±14.8 ml/min vs 69.5±17.7 ml/min, p<0.001], hemoglobin (11.5±2.1 g/dl vs 12.9±1.8 g/dl, p<0.001) and albumin [3.67±0.54 g/dl vs 4±0.44 g/dl, p=0.003] levels were lower in patients with AF aged ≥75 years compared to the patients with AF aged 65-75 years. Conclusion: Comorbidities especially hypertension and chronic kidney disease are more frequently observed in patients with AF as age increases. It is important to remember that in elderly patients with AF, it is essential to manage not only the arrhythmia itself but also any additional comorbidities.

Etik Beyan

This retrospective study was approved by the Balikesir University Clinical Research Ethics Committee according to the Declaration of Helsinki (Decision no: 2023/137; Date: 11.10.2023).

Destekleyen Kurum

None

Teşekkür

None

Kaynakça

  • Chugh, S. S., Havmoeller, R., Narayanan, K., Singh, D., Rienstra, M., Benjamin, E. J., Gillum, R. F., Kim, Y. H., McAnulty, J. H., Jr, Zheng, Z. J., Forouzanfar, M. H., Naghavi, M., Mensah, G. A., Ezzati, M., & Murray, C. J. (2014). Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation, 129(8), 837–847. https://doi.org/10.1161/CIRCULATIONAHA.113.005119
  • Li, H. (2019). Clinical Characteristics and Risk Factors of Atrial Fibrillation in the Elderly. Journal of Geriatric Medicine, 1(1), 15–21. https://doi.org/10.30564/jgm.v1i01.735
  • Krijthe, B. P., Kunst, A., Benjamin, E. J., Lip, G. Y., Franco, O. H., Hofman, A., Witteman, J. C., Stricker, B. H., & Heeringa, J. (2013). Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. European heart journal, 34(35), 2746–2751. https://doi.org/10.1093/eurheartj/eht280
  • Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., Dai, S., Ford, E. S., Fox, C. S., Franco, S., Fullerton, H. J., Gillespie, C., Hailpern, S. M., Heit, J. A., Howard, V. J., Huffman, M. D., Judd, S. E., Kissela, B. M., Kittner, S. J., Lackland, D. T., … American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2014). Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation, 129(3), e28–e292. https://doi.org/10.1161/01.cir.0000441139.02102.80
  • Heeringa, J., van der Kuip, D. A., Hofman, A., Kors, J. A., van Herpen, G., Stricker, B. H., Stijnen, T., Lip, G. Y., & Witteman, J. C. (2006). Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. European heart journal, 27(8), 949–953. https://doi.org/10.1093/eurheartj/ehi825
  • Kannel, W. B., Abbott, R. D., Savage, D. D., & McNamara, P. M. (1982). Epidemiologic features of chronic atrial fibrillation: the Framingham study. The New England journal of medicine, 306(17), 1018–1022. https://doi.org/10.1056/NEJM198204293061703
  • Society of Cardiology, Chinese Medical Association (2004). Retrospective investigation of hospitalized patients with atrial fibrillation in mainland China. Chinese medical journal, 117(12), 1763–1767. Halcox, J. P. J., Wareham, K., Cardew, A., Gilmore, M., Barry, J. P., Phillips, C., & Gravenor, M. B. (2017). Assessment of Remote Heart Rhythm Sampling Using the AliveCor Heart Monitor to Screen for Atrial Fibrillation: The REHEARSE-AF Study. Circulation, 136(19), 1784–1794. https://doi.org/10.1161/CIRCULATIONAHA.117.030583
  • Siontis, K. C., Gersh, B. J., Killian, J. M., Noseworthy, P. A., McCabe, P., Weston, S. A., Roger, V. L., & Chamberlain, A. M. (2016). Typical, atypical, and asymptomatic presentations of new-onset atrial fibrillation in the community: Characteristics and prognostic implications. Heart rhythm, 13(7), 1418–1424. https://doi.org/10.1016/j.hrthm.2016.03.003
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  • Go, A. S., Hylek, E. M., Phillips, K. A., Chang, Y., Henault, L. E., Selby, J. V., & Singer, D. E. (2001). Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA, 285(18), 2370–2375. https://doi.org/10.1001/jama.285.18.2370
  • Psaty, B. M., Manolio, T. A., Kuller, L. H., Kronmal, R. A., Cushman, M., Fried, L. P., White, R., Furberg, C. D., & Rautaharju, P. M. (1997). Incidence of and risk factors for atrial fibrillation in older adults. Circulation, 96(7), 2455–2461. https://doi.org/10.1161/01.cir.96.7.2455
  • Rich, M. W., Chyun, D. A., Skolnick, A. H., Alexander, K. P., Forman, D. E., Kitzman, D. W., Maurer, M. S., McClurken, J. B., Resnick, B. M., Shen, W. K., Tirschwell, D. L., American Heart Association Older Populations Committee of the Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council, & American College of Cardiology; and American Geriatrics Society (2016). Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society. Journal of the American College of Cardiology, 67(20), 2419–2440. https://doi.org/10.1016/j.jacc.2016.03.004
  • Nieuwlaat, R., Capucci, A., Camm, A. J., Olsson, S. B., Andresen, D., Davies, D. W., Cobbe, S., Breithardt, G., Le Heuzey, J. Y., Prins, M. H., Lévy, S., Crijns, H. J., & European Heart Survey Investigators (2005). Atrial fibrillation management: a prospective survey in ESC member countries: the Euro Heart Survey on Atrial Fibrillation. European heart journal, 26(22), 2422–2434. https://doi.org/10.1093/eurheartj/ehi505
  • Fumagalli, S., Nieuwlaat, R., Tarantini, F., de Vos, C. B., Werter, C. J., Le Heuzey, J. Y., Marchionni, N., & Crijns, H. J. (2012). Characteristics, management and prognosis of elderly patients in the Euro Heart Survey on atrial fibrillation. Aging clinical and experimental research, 24(5), 517–523. https://doi.org/10.3275/8408
  • Go, A. S., Hylek, E. M., Phillips, K. A., Chang, Y., Henault, L. E., Selby, J. V., & Singer, D. E. (2001). Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA, 285(18), 2370–2375. https://doi.org/10.1001/jama.285.18.2370
  • Singer, D. E., Chang, Y., Fang, M. C., Borowsky, L. H., Pomernacki, N. K., Udaltsova, N., & Go, A. S. (2009). The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Annals of internal medicine, 151(5), 297–305. https://doi.org/10.7326/0003-4819-151-5-200909010-00003
  • Mant, J., Hobbs, F. D., Fletcher, K., Roalfe, A., Fitzmaurice, D., Lip, G. Y., Murray, E., BAFTA investigators, & Midland Research Practices Network (MidReC) (2007). Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet (London, England), 370(9586), 493–503. https://doi.org/10.1016/S0140-6736(07)61233-1
  • Di Pasquale, G., Mathieu, G., Maggioni, A. P., Fabbri, G., Lucci, D., Vescovo, G., Pirelli, S., Chiarella, F., Scherillo, M., Gulizia, M. M., Gussoni, G., Colombo, F., Panuccio, D., Nozzoli, C., Berisso, M. Z., & ATA-AF Investigators (2013). Current presentation and management of 7148 patients with atrial fibrillation in cardiology and internal medicine hospital centers: the ATA AF study. International journal of cardiology, 167(6), 2895–2903. https://doi.org/10.1016/j.ijcard.2012.07.019
  • Hylek, E. M., Evans-Molina, C., Shea, C., Henault, L. E., & Regan, S. (2007). Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation, 115(21), 2689–2696. https://doi.org/10.1161/CIRCULATIONAHA.106.653048
  • Boriani, G., Laroche, C., Diemberger, I., Fantecchi, E., Popescu, M. I., Rasmussen, L. H., Sinagra, G., Petrescu, L., Tavazzi, L., Maggioni, A. P., & Lip, G. Y. (2015). Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF Pilot General Registry. The American journal of medicine, 128(5), 509–18.e2. https://doi.org/10.1016/j.amjmed.2014.11.026
  • Orimo H, Ito H, Suzuki T, Araki A, Hosoi T, Sawabe M. Reviewing the definition of “elderly”. Geriatrics & gerontology international. 2006;6(3):149-158. doi: 10.1111/j.1447-0594.2006.00341.x
  • Lee, S. B., Oh, J. H., Park, J. H., Choi, S. P., & Wee, J. H. (2018). Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department. Clinical and experimental emergency medicine, 5(4), 249–255. https://doi.org/10.15441/ceem.17.261
  • Van Gelder, I. C., Rienstra, M., Bunting, K. V., Casado-Arroyo, R., Caso, V., Crijns, H. J. G. M., De Potter, T. J. R., Dwight, J., Guasti, L., Hanke, T., Jaarsma, T., Lettino, M., Løchen, M. L., Lumbers, R. T., Maesen, B., Mølgaard, I., Rosano, G. M. C., Sanders, P., Schnabel, R. B., Suwalski, P., … ESC Scientific Document Group (2024). 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European heart journal, 45(36), 3314–3414. https://doi.org/10.1093/eurheartj/ehae176
  • Cockcroft, D. W., & Gault, M. H. (1976). Prediction of creatinine clearance from serum creatinine. Nephron, 16(1), 31–41. https://doi.org/10.1159/000180580
  • Coresh, J., & Stevens, L. A. (2006). Kidney function estimating equations: where do we stand?. Current opinion in nephrology and hypertension, 15(3), 276–284. https://doi.org/10.1097/01.mnh.0000222695.84464.61 American Diabetes Association (2010). Diagnosis and classification of diabetes mellitus. Diabetes care, 33 Suppl 1(Suppl 1), S62–S69. https://doi.org/10.2337/dc10-S062
  • Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., Lip, G. Y. H., … Authors/Task Force Members: (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Journal of hypertension, 36(10), 1953–2041. https://doi.org/10.1097/HJH.0000000000001940
  • Feinberg, W. M., Blackshear, J. L., Laupacis, A., Kronmal, R., & Hart, R. G. (1995). Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Archives of internal medicine, 155(5), 469–473.
  • Andersson, T., Magnuson, A., Bryngelsson, I. L., Frøbert, O., Henriksson, K. M., Edvardsson, N., & Poçi, D. (2013). All-cause mortality in 272,186 patients hospitalized with incident atrial fibrillation 1995-2008: a Swedish nationwide long-term case-control study. European heart journal, 34(14), 1061–1067. https://doi.org/10.1093/eurheartj/ehs469
  • Fang, M. C., Singer, D. E., Chang, Y., Hylek, E. M., Henault, L. E., Jensvold, N. G., & Go, A. S. (2005). Gender differences in the risk of ischemic stroke and peripheral embolism in atrial fibrillation: the AnTicoagulation and Risk factors In Atrial fibrillation (ATRIA) study. Circulation, 112(12), 1687–1691. https://doi.org/10.1161/CIRCULATIONAHA.105.553438
  • Benjamin, E. J., Levy, D., Vaziri, S. M., D'Agostino, R. B., Belanger, A. J., & Wolf, P. A. (1994). Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA, 271(11), 840–844.
  • Huxley, R. R., Lopez, F. L., Folsom, A. R., Agarwal, S. K., Loehr, L. R., Soliman, E. Z., Maclehose, R., Konety, S., & Alonso, A. (2011). Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: the Atherosclerosis Risk in Communities (ARIC) study. Circulation, 123(14), 1501–1508. https://doi.org/10.1161/CIRCULATIONAHA.110.009035
  • Movahed, M. R., Hashemzadeh, M., & Jamal, M. M. (2005). Diabetes mellitus is a strong, independent risk for atrial fibrillation and flutter in addition to other cardiovascular disease. International journal of cardiology, 105(3), 315–318. https://doi.org/10.1016/j.ijcard.2005.02.050
  • Huxley, R. R., Filion, K. B., Konety, S., & Alonso, A. (2011). Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation. The American journal of cardiology, 108(1), 56–62. https://doi.org/10.1016/j.amjcard.2011.03.004
  • Palaparthi, E. C., Titty, N. A., Bhuyar, B. K., Gudimalla, A., Nandyala, P. S. K. R., Vivekanandan, V., & Kandimalla, R. (2025). Atrial Fibrillation in Geriatric Patients: A Cross-Sectional Analysis of Risk Factors and Disease Patterns. Cureus, 17(4), e82285. https://doi.org/10.7759/cureus.82285
  • Fumagalli, S., Said, S. A. M., Laroche, C., Gabbai, D., Marchionni, N., Boriani, G., Maggioni, A. P., Popescu, M. I., Rasmussen, L. H., Crijns, H. J. G. M., Lip, G. Y. H., & EORP-AF Investigators (2015). Age-Related Differences in Presentation, Treatment, and Outcome of Patients With Atrial Fibrillation in Europe: The EORP-AF General Pilot Registry (EURObservational Research Programme-Atrial Fibrillation). JACC. Clinical electrophysiology, 1(4), 326–334. https://doi.org/10.1016/j.jacep.2015.02.019
  • Weaving, G., Batstone, G. F., & Jones, R. G. (2016). Age and sex variation in serum albumin concentration: an observational study. Annals of clinical biochemistry, 53(Pt 1), 106–111. https://doi.org/10.1177/0004563215593561
  • Harrison, S. J., Messner, J., Leeder, D. J., Stephenson, J., & Sidhom, S. A. (2017). Are Albumin Levels a Good Predictor of Mortality in Elderly Patients with Neck of Femur Fractures?. The journal of nutrition, health & aging, 21(6), 699–703. https://doi.org/10.1007/s12603-016-0799-6
  • Cooper, J. K., & Gardner, C. (1989). Effect of aging on serum albumin. Journal of the American Geriatrics Society, 37(11), 1039–1042. https://doi.org/10.1111/j.1532-5415.1989.tb06917.x
  • Bansal, N., Fan, D., Hsu, C. Y., Ordonez, J. D., Marcus, G. M., & Go, A. S. (2013). Incident atrial fibrillation and risk of end-stage renal disease in adults with chronic kidney disease. Circulation, 127(5), 569–574. https://doi.org/10.1161/CIRCULATIONAHA.112.123992
  • Zimmerman, D., Sood, M. M., Rigatto, C., Holden, R. M., Hiremath, S., & Clase, C. M. (2012). Systematic review and meta-analysis of incidence, prevalence and outcomes of atrial fibrillation in patients on dialysis. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 27(10), 3816–3822. https://doi.org/10.1093/ndt/gfs416
  • Hess, P. L., Kim, S., Piccini, J. P., Allen, L. A., Ansell, J. E., Chang, P., Freeman, J. V., Gersh, B. J., Kowey, P. R., Mahaffey, K. W., Thomas, L., Peterson, E. D., & Fonarow, G. C. (2013). Use of evidence-based cardiac prevention therapy among outpatients with atrial fibrillation. The American journal of medicine, 126(7), 625–32.e1. https://doi.org/10.1016/j.amjmed.2013.01.037
  • Al Chekakie, M. O., Welles, C. C., Metoyer, R., Ibrahim, A., Shapira, A. R., Cytron, J., Santucci, P., Wilber, D. J., & Akar, J. G. (2010). Pericardial fat is independently associated with human atrial fibrillation. Journal of the American College of Cardiology, 56(10), 784–788. https://doi.org/10.1016/j.jacc.2010.03.071
Toplam 42 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Geriatri ve Gerontoloji
Bölüm Araştırma Makalesi
Yazarlar

Onur Argan 0000-0001-7745-7736

Özge Özgün 0000-0002-0104-6604

Özgen Şafak 0000-0001-8245-0117

Tarık Yıldırım 0000-0002-6314-7371

Mehmet Tolga Hekim 0000-0001-6540-2244

Seda Elçim Yıldırım 0000-0001-5175-0491

Didar Elif Akgün 0000-0001-6618-180X

Eyüp Avcı 0000-0002-7790-8450

Halil Lütfi Kısacık 0000-0003-1102-8239

Gönderilme Tarihi 6 Ocak 2026
Kabul Tarihi 25 Mart 2026
Yayımlanma Tarihi 30 Nisan 2026
DOI https://doi.org/10.33716/bmedj.1857891
IZ https://izlik.org/JA53XM43AP
Yayımlandığı Sayı Yıl 2026 Cilt: 10 Sayı: 1

Kaynak Göster

APA Argan, O., Özgün, Ö., Şafak, Ö., Yıldırım, T., Hekim, M. T., Yıldırım, S. E., Akgün, D. E., Avcı, E., & Kısacık, H. L. (2026). Age-Related Differences in Elderly Patients with Atrial Fibrillation. Balıkesir Medical Journal, 10(1), 1-10. https://doi.org/10.33716/bmedj.1857891