Clinical characteristics and management of paroxysmal junctional tachycardia in the elderly.
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.


OBJECTIVE
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.


CONCLUSIONS
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.
Yangni N'Da'
O
O
Service de cardiologie, Centre hospitalier universitaire de Brabois, Vandoeuvre-lès-Nancy.
Brembilla-Perrot
B
B
D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000503:physiopathology* / Q000628:therapy; D013614:Tachycardia, Paroxysmal / Q000503:physiopathology* / Q000628:therapy; D016896:Treatment Outcome