Electrophysiologic characteristics and results of radiofrequency catheter ablation in elderly patients with atrioventricular nodal reentrant tachycardia.

Background: As in the general population, atrioventricular nodal reentrant tachycardia (AVNRT) is the most common regular supraventricular tachycardia in the elderly patients. We tried to compare electrophysiologic characteristics, efficacy, and risks of the radiofrequency (RF) catheter ablation of the slow pathway in elderly and young patients with AVNRT.

Methods: Between April 2001 and March 2005, 268 consecutive patients (190 females; mean age, 49 +/- 14 years) with AVNRT underwent RF catheter ablation at our institution. The patients were categorized into 2 groups: group 1 consists of patients younger than 65 years (n = 156), and group 2 consists of patients 65 years or older (n = 112).

Results: Compared with the younger subgroup, elderly patients more often had structural heart disease (11.6% vs 2.5%, P = .004), but there were no statistically significant differences in sex and symptoms during tachycardia (all P > .05). AVNRT cycle length was significantly longer in group 2 than in group 1 patients (P = .005). Among the conduction intervals of tachycardia, only atrio-his interval was significantly longer in group 2 patients (P = .007). The ablation fluoroscopy time, RF pulse duration, target temperature, applied energy, and number of RF applications were comparable in the 2 groups (All P > .05). Risk of atrioventricular block, pericardial effusion, and vascular thrombosis were similar in both groups (All P > .05). During follow-up with duration of 14 months, similar rate of recurrence was observed in the 2 groups (P = .94).

Conclusions: In elderly patients, slow pathway ablation is as effective and safe as in younger patients. Therefore, when considering different treatment options in elderly patients, an increased risk of complications or lower efficacy should not be a factor in determining the best therapeutic approach.