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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Indian+Pacing+Electrophysiol+J 2015 ; 15 (1): 32-42 Nephropedia Template TP
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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 PMID25852241show 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.