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首页> 外文期刊>Heart rhythm: the official journal of the Heart Rhythm Society >Mortality and safety of catheter ablation for antiarrhythmic drug-refractory ventricular tachycardia in elderly patients with coronary artery disease.
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Mortality and safety of catheter ablation for antiarrhythmic drug-refractory ventricular tachycardia in elderly patients with coronary artery disease.

机译:老年冠心病患者抗心律失常药物难治性室性心动过速的导管消融术的死亡率和安全性。

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摘要

BACKGROUND: As the population ages, recurrent ventricular tachycardia (VT) is increasingly encountered in elderly patients with ischemic heart disease. Radiofrequency catheter ablation is useful for reducing VT therapy in patients with an implantable defibrillator. The utility of radiofrequency catheter ablation in the elderly is not well defined. OBJECTIVE: The purpose of this study was to evaluate the prognosis and safety of radiofrequency catheter ablation of postinfarct VT in elderly patients. METHODS: Radiofrequency catheter ablation was performed in 285 consecutive patients with recurrent postinfarct VT refractory to antiarrhythmic drugs. Mortality and outcomes were compared for an elderly group (age >or=75 years, n = 72) and a younger group (age <75 years, n = 213). RESULTS: The groups were similar with regard to baseline characteristics, except for a greater number of females in the elderly group (20.8% vs 10.8%, P = .03). Inducible VTs were abolished or modified in 79.2% of the elderly group and 87.8% of the younger group (P = .12). Major complications occurred in 5.6% of elderly patients and 2.3% of younger patients (P = .48). Periprocedural mortality was similar between both groups (2/72 in elderly and 9/213 in younger group, P = .74). During mean follow-up of 42 +/- 33 months, 50.0% of the elderly group and 35.2% of the younger group died (P = .08). No VT was observed in 63.9% of the elderly patients and 60.1% of the younger patients, respectively (mean follow-up 18 +/- 24 months, P = .80). CONCLUSION: Outcomes of catheter ablation are similar for selected elderly and younger patients. Advanced age should not preclude ablation when recurrent VT is adversely affecting quality of life in elderly patients who otherwise have a reasonable expectation for survival.
机译:背景:随着人口的老龄化,老年缺血性心脏病患者反复出现室性心动过速(VT)。射频导管消融可用于减少植入式除颤器患者的VT治疗。射频消融在老年人中的用途尚不明确。目的:本研究旨在评估老年患者梗死后室速射频消融的预后和安全性。方法:射频消融连续285例复发性梗死后室速(抗心律失常药物)的患者。比较了老年组(年龄≥75岁,n = 72)和年轻组(年龄<75岁,n = 213)的死亡率和结局。结果:各组在基线特征方面相似,除了老年组中女性人数较多(20.8%vs 10.8%,P = .03)。诱导型室速在老年组中占79.2%,在年轻组中占87.8%(P = 0.12)。主要并发症发生在5.6%的老年患者和2.3%的年轻患者中(P = .48)。两组的围手术期死亡率相似(老年组2/72,年轻组9/213,P = 0.74)。在平均42 +/- 33个月的随访期间,老年组50.0%死亡,年轻组35.2%死亡(P = 0.08)。分别在63.9%的老年患者和60.1%的年轻患者中未观察到VT(平均随访18 +/- 24个月,P = .80)。结论:选定的老年和年轻患者的导管消融结果相似。当复发性VT对老年患者的生活质量产生不利影响时,高龄不应排除消融,否则他们对生存期有合理的期望。

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