0080: Elderly patients and preexcitation syndrome. Why they should be managed as young patients?

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• 作者：Arnaud Olivier⁽¹⁾ ; Nicolas Girerd⁽²⁾ ; Bé ; atrice Brembilla-Perrot ; ⁽³⁾ ; ^{b.brembilla-perrot@chu-nancy.fr" class="auth_mail" title="E-mail the corresponding author}
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：75-76
• 全文大小：504 K

文摘

Few data are reported on pre-excitation syndrome (PS) in the elderly. The aim was to investigate the influence of advancing age on clinical presentation, treatment and long-term outcome of PS.

Methods

961 patients referred for PS were referred for PS and electro-physiological study (EPS). Clinical history, echocardiography and treatment were collected. Patients were followed from 3 months up to 10 years (5.3±5 years).

Results

There were 72 patients ≥60y (mean 68.5±6), 889 patients <60y (mean 30.5±14). Electrophysiological data and recourse to accessory pathway (AP) ablation (43% vs. 48.5%, p=0.375) did not significantly differ between the two groups. Older patients more often had symptomatic forms (81% vs. 63%, p=0.003) and more often had history of spontaneous atrial fibrillation (AF)(8% vs. 3%, p=0.01) or poorly-tolerated arrhythmias (18%vs. 7%, p=0.0009). In multivariable analysis, patients ≥60 had a significantly higher risk of history of AF (OR=4.2, 2.1-8.3, p=0.001) and poorly-tolerated arrhythmias (OR=3.8, 1.8-8.1, p=0.001). In patients who underwent AP ablation, age ≥60 was associated with an increased risk of major complication (9.6% vs. 1.9%, p=0.006). During follow-up, occurrence of AF (13.9% vs. 3.6%, p<0.001) and poorly-tolerated tachycardia (4.2% vs. 0.6%, p=0.001) were more frequent in patients ≥60 although frequency of ablation failure or recurrence was similar (20% vs. 15.5%, p=0.52). In multivariable analysis, patients ≥60 had a significantly higher risk of AF (OR=2.9, 1.2-6.8, p≤0.01).

Conclusions

Referring of older patients was infrequent in our clinical practice (7.5% of patients with a PS). Patients ≥60 have a higher risk of AF and poorly-tolerated tachycardia both at admission and during follow-up but also a higher risk of procedure complications. Nevertheless, given a risk of important complications below 10%, the risk/benefit balance appears to favor AP ablation in the elderly.