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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Indian+Pacing+Electrophysiol+J
2015 ; 15
(1
): 32-42
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What is The Utility of Electrophysiological Study in Elderly Patients with
Syncope and Heart Disease?
#MMPMID25852241
Aslam R
; Girerd N
; Brembilla-Perrot B
Indian Pacing Electrophysiol J
2015[Jan]; 15
(1
): 32-42
PMID25852241
show ga
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.