Management of elderly patients with the Wolff-Parkinson-White syndrome: is less aggressive treatment justified?
Identifieur interne : 002534 ( Main/Exploration ); précédent : 002533; suivant : 002535Management of elderly patients with the Wolff-Parkinson-White syndrome: is less aggressive treatment justified?
Auteurs : G. Heinz [Autriche] ; G. Kreiner [Autriche] ; S. Radosztics [Autriche] ; P. Siostrzonek [Autriche] ; H. Gössinger [Autriche]Source :
- The clinical investigator [ 0941-0198 ] ; 1993-07-01.
Abstract
Summary: To study the age-related differences in Wolff-Parkinson-White syndrome an elderly group of 20 patients aged 40–65 years was compared to a younger group of 26 patients aged 18–39 years with respect to clinical profile and electrophysiological characteristics. The two groups were comparable in terms of the mechanism of reentry tachycardia, accessory pathway location, the number of patients reporting syncopal episodes, and the incidence of inducible and/or documented atrial flutter/fibrillation while only elderly patients had also atrial tachycardias. The elderly group was characterized by a higher incidence of associated organic heart disease and a significantly higher percentage of resuscitation from circulatory arrest. Cardiocirculatory arrest due to arrhythmias was the event leading to transferral to our hospital in 30% of elderly patients compared with 7.7% in the younger group. Analogous results were obtained when stratified according to the age at manifestation of tachyarrhythmias (< 30, ≥ 30 years), a history of cardiopulmonary resuscitation being the only significant difference between the two groups. There was no difference in any electrophysiologic parameter between the two age groups or with respect to the age at manifestation of arrhythmias. It is concluded that elderly patients with the Wolf-Parkinson-White syndrome should be managed as aggressively as their younger counterparts. In particular, manifestation of arrhythmias due to Wolff-Parkinson-White syndrome beyond age 30 should not be regarded as a more benign variation of the syndrome. Explanations for the more frequent history of resuscitation in the elderly include the presence of organic heart disease with impairment of left or right ventricular function and differences in the management of these patients.
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DOI: 10.1007/BF00208473
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Heinz</name><affiliation wicri:level="3"><country xml:lang="fr">Autriche</country><wicri:regionArea>Klinik für Innere Medizin II, Abteilung für Kardiologie, Währinger Gürtel 18-20, A-1090, Wien</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Kreiner, G" sort="Kreiner, G" uniqKey="Kreiner G" first="G." last="Kreiner">G. Kreiner</name><affiliation wicri:level="3"><country xml:lang="fr">Autriche</country><wicri:regionArea>Klinik für Innere Medizin II, Abteilung für Kardiologie, Währinger Gürtel 18-20, A-1090, Wien</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Radosztics, S" sort="Radosztics, S" uniqKey="Radosztics S" first="S." last="Radosztics">S. 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Gössinger</name><affiliation wicri:level="3"><country xml:lang="fr">Autriche</country><wicri:regionArea>Klinik für Innere Medizin II, Abteilung für Kardiologie, Währinger Gürtel 18-20, A-1090, Wien</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">The clinical investigator</title><title level="j" type="abbrev">Clin Investig</title><idno type="ISSN">0941-0198</idno><idno type="eISSN">1432-1440</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="1993-07-01">1993-07-01</date><biblScope unit="volume">71</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="519">519</biblScope><biblScope unit="page" to="523">523</biblScope></imprint><idno type="ISSN">0941-0198</idno></series><idno type="istex">5F4A5D0B04246AF12BFFA74DA1BA81B2EB7A879A</idno><idno type="DOI">10.1007/BF00208473</idno><idno type="ArticleID">Art2</idno><idno type="ArticleID">BF00208473</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0941-0198</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Summary: To study the age-related differences in Wolff-Parkinson-White syndrome an elderly group of 20 patients aged 40–65 years was compared to a younger group of 26 patients aged 18–39 years with respect to clinical profile and electrophysiological characteristics. The two groups were comparable in terms of the mechanism of reentry tachycardia, accessory pathway location, the number of patients reporting syncopal episodes, and the incidence of inducible and/or documented atrial flutter/fibrillation while only elderly patients had also atrial tachycardias. The elderly group was characterized by a higher incidence of associated organic heart disease and a significantly higher percentage of resuscitation from circulatory arrest. Cardiocirculatory arrest due to arrhythmias was the event leading to transferral to our hospital in 30% of elderly patients compared with 7.7% in the younger group. Analogous results were obtained when stratified according to the age at manifestation of tachyarrhythmias (< 30, ≥ 30 years), a history of cardiopulmonary resuscitation being the only significant difference between the two groups. There was no difference in any electrophysiologic parameter between the two age groups or with respect to the age at manifestation of arrhythmias. It is concluded that elderly patients with the Wolf-Parkinson-White syndrome should be managed as aggressively as their younger counterparts. In particular, manifestation of arrhythmias due to Wolff-Parkinson-White syndrome beyond age 30 should not be regarded as a more benign variation of the syndrome. Explanations for the more frequent history of resuscitation in the elderly include the presence of organic heart disease with impairment of left or right ventricular function and differences in the management of these patients.</div></front></TEI><affiliations><list><country><li>Autriche</li></country><region><li>Vienne (Autriche)</li></region><settlement><li>Vienne (Autriche)</li></settlement></list><tree><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Heinz, G" sort="Heinz, G" uniqKey="Heinz G" first="G." last="Heinz">G. Heinz</name></region><name sortKey="Gossinger, H" sort="Gossinger, H" uniqKey="Gossinger H" first="H." last="Gössinger">H. Gössinger</name><name sortKey="Kreiner, G" sort="Kreiner, G" uniqKey="Kreiner G" first="G." last="Kreiner">G. Kreiner</name><name sortKey="Radosztics, S" sort="Radosztics, S" uniqKey="Radosztics S" first="S." last="Radosztics">S. Radosztics</name><name sortKey="Siostrzonek, P" sort="Siostrzonek, P" uniqKey="Siostrzonek P" first="P." last="Siostrzonek">P. Siostrzonek</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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