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Original research
Association of age with clinical features and ablation outcomes of paroxysmal supraventricular tachycardias
  1. Pablo Ávila1,2,
  2. David Calvo3,
  3. María Tamargo1,2,
  4. Aitor Uribarri2,4,
  5. Tomas Datino1,2,
  6. Angel Arenal1,2,
  7. Felipe Atienza1,2,
  8. Nina Soto1,2,
  9. Francisco Fernández-Avilés1,2,
  10. Esteban González-Torrecilla1,2
  1. 1 Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
  2. 2 CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
  3. 3 Cardiology Department, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
  4. 4 Cardiology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
  1. Correspondence to Dr Pablo Ávila, Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid 28007, Spain; pabloavilaalonso{at}gmail.com

Abstract

Objective The role of age in clinical characteristics and catheter ablation outcomes of atrioventricular nodal re-entrant tachycardia (AVNRT) or orthodromic atrioventricular re-entrant tachycardia (AVRT) has been assessed in retrospective studies categorising age by arbitrary cut-offs, but contemporary analyses of age-related trends are lacking. We aimed to study the relationship of age with epidemiological, clinical features and catheter ablation outcomes of AVNRT and AVRT.

Methods We recruited 600 patients (median age 56 years, 60% female) with a confirmed diagnosis of AVNRT (n=455) or AVRT (n=145) by means of an electrophysiological study. They were interrogated for arrhythmia-related symptoms with a structured questionnaire and followed up to 1 year. We analysed age as a continuous variable using regression models and adjusting for relevant covariables.

Results Both typical and atypical forms of AVNRT upraised with age while AVRT decreased (p<0.001 by regression). Female sex predominance in AVNRT was not observed in older patients. Overall, these tachycardias became more symptomatic with ageing despite a longer tachycardia cycle length (p<0.001) and regardless of the presence of structural heart disease, with a higher proportion of dizziness, syncope, chest pain or dyspnoea (p<0.005 for all) and a lower presence of palpitations or neck pounding (p<0.001 for both). Age was not associated with catheter ablation acute success, periprocedural complications or 1-year recurrence rates (p>0.05 for all).

Conclusions Age, evaluated as a continuous variable, had a significant association with the clinical profile of patients with AVNRT and AVRT. Nevertheless, catheter ablation outcomes and complications were not significantly related to patients’ age.

  • catheter ablation
  • tachycardia
  • supraventricular

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Twitter @auribarri, @atienza_felipe

  • Contributors PA and EG-T designed the study. PA, DC, MT, AU and EG-T identified the patients and collected the data. PA, DC and EG-T conducted the data analysis and drafted the manuscript. All authors provided substantial contribution to the interpretation of the results and revision of the manuscript for important intellectual content. All authors provided final approval of the version to be published in agreement with ensuring the integrity and accuracy of the work. The corresponding author (PA) attests that all the listed authors meet the authorship criteria.

  • Funding MT is funded by a Rio Hortega contract (CM20/00054). NS is funded by the Spanish Heart Rhythm Association for training in cardiac electrophysiology.

  • Competing interests PA received teaching honoraria from Medtronic and served as Advisory Board member for Boston Scientific. FA served as Advisory Board member for Medtronic and MicroPort. TD received teaching honoraria from Medtronic. AA is a consultant for Medtronic and Boston Scientific. The remaining authors do not have disclosures to declare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.