心房颤动是一种临床上最常见的且与年龄相关的持续性心律失常。随着年龄的增长，心房颤动的患病率及心房颤动相关卒中的发病率均逐渐增加。老年患者由于认知及各器官功能减退，加之共病、并发症增多，服用药物也随之增多，其抗凝治疗变得复杂。新型口服抗凝药物增加了老年心房颤动患者的治疗选择。现就老年非瓣膜性心房颤动患者的抗凝现状、抗凝治疗的必要性及挑战、用药选择等问题进行回顾综述，以助临床医生合理选择抗凝治疗方案。“,”Atrial fibrillation (AF) is one of the most common and age-related persistent arrhythmias. With the increase of age, the prevalence of AF and the incidence of atrial fibrillation-related stroke are increased. Due to the decline of cognition and function of various organs, coupled with the increase of comorbities and complications, the types of drug use also are increased in elderly patients, and their anticoagulant therapy has become complex. New anticoagulant drugs increase the choice of treatment in elderly patients with AF. This article reviews the clinical characteristics, necessity, challenge and drug selection of anticoagulant therapy in elderly patients with non-valvular AF to provide information for rational anticoagulant therapy.