Wolff-Parkinson-White syndrome in the elderly: clinical and electrophysiological findings.
BACKGROUND
Screening for Wolff-Parkinson-White (WPW) syndrome is recommended in children and young adults. The aim of this study was to evaluate the clinical and electrophysiological characteristics of patent WPW syndrome in subjects > or =60 years of age.


METHODS
Four-hundred and fifty-nine consecutive patients with WPW syndrome, aged 8-80 years, were recruited; 32 (7%) of these patients were > or =60 years of age. The clinical, electrophysiological and therapeutic data for these patients were evaluated.


RESULTS
Sixteen men and 16 women, aged 60-81 years (67+/-4.5), were admitted for resuscitated sudden death (1), rapid atrial fibrillation (4), syncope (4), or junctional tachycardia (13); 10 patients were asymptomatic (10). Left lateral bundles of Kent were detected more frequently in patients over 60 years (56%) than in those<60 years of age (40.5%). Reciprocal tachycardia was induced in 58% of subjects<60 years of age and 53% of those > or =60 years old (difference not significant); atrial fibrillation was more frequent in subjects > or =60 years of age (37.5% vs. 19%) (p<0.05). The incidence of malignant forms of WPW syndrome was identical in older and younger subjects. Ablation of the accessory pathway was indicated 18 times; effective ablation of a left bundle of Kent required a second intervention more often in patients > or =60 years of age (22% vs. 5%) (p<0.05).


CONCLUSIONS
WPW syndrome is not uncommon in subjects over 60 years of age (7%). Left lateral accessory pathways, that have similar conduction properties to those in much younger subjects, are common. Ablation of the bundle of Kent is often difficult but is indicated in symptomatic subjects or those with more serious forms of WPW syndrome.
Brembilla-Perrot
B
B
Cardiologie, CHU de Brabois, 54500 Vandoeuvre les Nancy, France. b.brembilla-perrot@chu-nancy.fr
Yangni N'da
O
O
Huttin
O
O
Chometon
F
F
Groben
L
L
Christophe
C
C
Benzaghou
N
N
Luporsi
J D
JD
Tatar
C
C
Bertrand
J
J
Ammar
S
S
Cedano
G
G
Zhang
N
N
Beurrier
D
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D002648:Child; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D054139:Tachycardia, Reciprocating / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000503:physiopathology* / Q000601:surgery