Against this background, the present study investigated differences in the clinical characteristics, prescription of OACs, incidence of death, and cause of death in elderly AF patients, and evaluated whether OACs and comorbidities are independently associated with prognosis in these patients. Methods Study Patients and Data Collection The present study was a hospital-based retrospective observational study. All patients with AF (paroxysmal or sustained) as of 2017 according to the electronic medical record (EMR) system were picked up from 1997. Cardiologists and biomedical engineers reviewed the electrocardiograms (ECGs) and medical records, and ECG-documented A trial fibrillation (AF) is a common arrhythmia in elderly patents. The prevalence and incidence rate of AF increase with age, with more than 70% of those diagnosed with AF being ≥65 years of age. 1,2 Although comorbidities increase with age, 3 elderly AF patients are likely to have a greater number of comorbidities. 2,4,5 The risk of developing embolic events is 5-fold higher in patients with AF than in those with sinus rhythm, 6 leaving patients bedridden or requiring long-term care, and increasing the mortality rate. 7 Oral anticoagulants (OACs) significantly reduce the incidence of stroke in patients with AF. Allcause mortality and causes of death among patients with AF were recently examined in both randomized control trials 8 and in cohort studies. 9-12 The real-world cohort studies demonstrated that stroke-related deaths account for approximately 5-8% of all-cause deaths, with non-cardio