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What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease?
BACKGROUND: Syncope in elderly patients with heart disease is a growing problem. Its aetiological diagnosis is often difficult. We intended to investigate the value of the electrophysiological study (EPS) in old patients with syncope and heart disease. METHODS: EPS was performed in 182 consecutive p...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380693/ https://www.ncbi.nlm.nih.gov/pubmed/25852241 http://dx.doi.org/10.1016/S0972-6292(16)30840-3 |
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author | Aslam, Rumas Girerd, Nicolas Brembilla-Perrot, Beatrice |
author_facet | Aslam, Rumas Girerd, Nicolas Brembilla-Perrot, Beatrice |
author_sort | Aslam, Rumas |
collection | PubMed |
description | BACKGROUND: Syncope in elderly patients with heart disease is a growing problem. Its aetiological diagnosis is often difficult. We intended to investigate the value of the electrophysiological study (EPS) in old patients with syncope and heart disease. METHODS: EPS was performed in 182 consecutive patients with syncope and heart disease, among whom 62 patients were ≥75 years old and 120 patients <75. RESULTS: Left ventricular ejection fraction was 43.9±11.7% in patients ≥75 and 41.1±12.6% in patients <75. During EPS, induced sustained ventricular arrhythmias were as frequent in both groups (27.4% in patients ≥75 versus 27.5% in patients <75, p=0.99) whereas AV conduction abnormalities were more frequent in older patients (37.1% in patients ≥75 versus 18.3% in patients<75, p<0.005). Syncope remained unexplained in 35.5% of patients ≥75 and in 51.7% of patients <75 (p<0.04). ICD was more likely to be implanted in younger patients than in patients ≥75 years (37.5% vs 21% respectively, p<0.009). During a mean follow-up period of 3.3±3 years, the 4-year-survival rate was 66.9±6.8 % in patients ≥75 and 75.9±6.2 % in patients <75 years. The main cause of death was heart failure in both groups. The factors related to a worse outcome in a multivariate analysis were low LVEF and higher age. CONCLUSION: Complete EPS allows the identification of treatable causes in a high proportion of elderly patients with syncope and heart disease. Yet, the prognosis of these patients is mainly related to LVEF and age. |
format | Online Article Text |
id | pubmed-4380693 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-43806932015-04-07 What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease? Aslam, Rumas Girerd, Nicolas Brembilla-Perrot, Beatrice Indian Pacing Electrophysiol J Original Article BACKGROUND: Syncope in elderly patients with heart disease is a growing problem. Its aetiological diagnosis is often difficult. We intended to investigate the value of the electrophysiological study (EPS) in old patients with syncope and heart disease. METHODS: EPS was performed in 182 consecutive patients with syncope and heart disease, among whom 62 patients were ≥75 years old and 120 patients <75. RESULTS: Left ventricular ejection fraction was 43.9±11.7% in patients ≥75 and 41.1±12.6% in patients <75. During EPS, induced sustained ventricular arrhythmias were as frequent in both groups (27.4% in patients ≥75 versus 27.5% in patients <75, p=0.99) whereas AV conduction abnormalities were more frequent in older patients (37.1% in patients ≥75 versus 18.3% in patients<75, p<0.005). Syncope remained unexplained in 35.5% of patients ≥75 and in 51.7% of patients <75 (p<0.04). ICD was more likely to be implanted in younger patients than in patients ≥75 years (37.5% vs 21% respectively, p<0.009). During a mean follow-up period of 3.3±3 years, the 4-year-survival rate was 66.9±6.8 % in patients ≥75 and 75.9±6.2 % in patients <75 years. The main cause of death was heart failure in both groups. The factors related to a worse outcome in a multivariate analysis were low LVEF and higher age. CONCLUSION: Complete EPS allows the identification of treatable causes in a high proportion of elderly patients with syncope and heart disease. Yet, the prognosis of these patients is mainly related to LVEF and age. Elsevier 2016-04-26 /pmc/articles/PMC4380693/ /pubmed/25852241 http://dx.doi.org/10.1016/S0972-6292(16)30840-3 Text en © 2015 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Aslam, Rumas Girerd, Nicolas Brembilla-Perrot, Beatrice What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease? |
title | What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease? |
title_full | What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease? |
title_fullStr | What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease? |
title_full_unstemmed | What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease? |
title_short | What is The Utility of Electrophysiological Study in Elderly Patients with Syncope and Heart Disease? |
title_sort | what is the utility of electrophysiological study in elderly patients with syncope and heart disease? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380693/ https://www.ncbi.nlm.nih.gov/pubmed/25852241 http://dx.doi.org/10.1016/S0972-6292(16)30840-3 |
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