O Yangni N'Da'1, B Brembilla-Perrot. 1. Service de cardiologie, Centre hospitalier universitaire de Brabois, Vandoeuvre-lès-Nancy.
Abstract
BACKGROUND: The proportion of elderly subjects is in progress. While atrial fibrillation is the most frequent arrhythmia after the age of 70 years, other tachycardias also occur in the elderly. AIMS: The aim of this study is to assess the clinical and electrophysiological characteristics of paroxysmal junctional tachycardia (PJT) in patients older than 70 years. METHODS: Eight hundred sixteen patients aged from 8 to 93 years have been consecutively recruited for PJT. Among them, 141 (17%) were older than 70 years. The clinical, electro-physiology and therapeutic data were studied. RESULTS: Forty-eight men and 93 women with an age range from 70 to 93 years (mean 76+/-5) were admitted for recurrent PJT. They were associated to cardiac decompensation in 10 cases, syncope in 26 cases, acute coronary syndrome in 14 cases and unexplained acute vascular event in 5 cases. The electro-physiological mechanism of the PJT was similar to the younger patients with a majority of nodal reentrant tachycardia (73%). Atypical nodal tachycardias were more frequent than in the youth (15 versus 4%). PJT ablation was indicated more frequently in elderly patients than in younger patients (79 versus 57%), but complications (7% versus 2.5%) and failures, especially related to atrial fibrillation induction (19% versus 5%) were more frequent in elderly patients. CONCLUSION: Junctional tachycardias are not rare in the elderly and should not be missed. A cautious medical treatment can be impeded by the presence of conduction troubles or comorbidities. If this approach is not efficacious, these subjects might take benefit from curative ablation, with still a 10% failure rate.
BACKGROUND: The proportion of elderly subjects is in progress. While atrial fibrillation is the most frequent arrhythmia after the age of 70 years, other tachycardias also occur in the elderly. AIMS: The aim of this study is to assess the clinical and electrophysiological characteristics of paroxysmal junctional tachycardia (PJT) in patients older than 70 years. METHODS: Eight hundred sixteen patients aged from 8 to 93 years have been consecutively recruited for PJT. Among them, 141 (17%) were older than 70 years. The clinical, electro-physiology and therapeutic data were studied. RESULTS: Forty-eight men and 93 women with an age range from 70 to 93 years (mean 76+/-5) were admitted for recurrent PJT. They were associated to cardiac decompensation in 10 cases, syncope in 26 cases, acute coronary syndrome in 14 cases and unexplained acute vascular event in 5 cases. The electro-physiological mechanism of the PJT was similar to the younger patients with a majority of nodal reentrant tachycardia (73%). Atypical nodal tachycardias were more frequent than in the youth (15 versus 4%). PJT ablation was indicated more frequently in elderly patients than in younger patients (79 versus 57%), but complications (7% versus 2.5%) and failures, especially related to atrial fibrillation induction (19% versus 5%) were more frequent in elderly patients. CONCLUSION: Junctional tachycardias are not rare in the elderly and should not be missed. A cautious medical treatment can be impeded by the presence of conduction troubles or comorbidities. If this approach is not efficacious, these subjects might take benefit from curative ablation, with still a 10% failure rate.
Authors: Béatrice Brembilla-Perrot; Jean Marc Sellal; Arnaud Olivier; Thibaut Villemin; Daniel Beurrier; Julie Vincent; Vladimir Manenti; Christian de Chillou; Erwan Bozec; Nicolas Girerd Journal: PLoS One Date: 2018-01-05 Impact factor: 3.240