Heinz G, Kreiner G, Radosztics S, Siostrzonek P, Gössinger H
Klinik für Innere Medizin II, Abteilung für Kardiologie, Wien.
Clin Investig. 1993 Jul;71(7):519-23. doi: 10.1007/BF00208473.
To study the age-related differences in Wolff-Parkinson-White syndrome an elderly group of 20 patients aged 40-65 years was compared to a younger group of 26 patients aged 18-39 years with respect to clinical profile and electrophysiological characteristics. The two groups were comparable in terms of the mechanism of reentry tachycardia, accessory pathway location, the number of patients reporting syncopal episodes, and the incidence of inducible and/or documented atrial flutter/fibrillation while only elderly patients had also atrial tachycardias. The elderly group was characterized by a higher incidence of associated organic heart disease and a significantly higher percentage of resuscitation from circulatory arrest. Cardiocirculatory arrest due to arrhythmias was the event leading to transferral to our hospital in 30% of elderly patients compared with 7.7% in the younger group. Analogous results were obtained when stratified according to the age at manifestation of tachyarrhythmias (< 30, > or = 30 years), a history of cardiopulmonary resuscitation being the only significant difference between the two groups. There was no difference in any electrophysiologic parameter between the two age groups or with respect to the age at manifestation of arrhythmias. It is concluded that elderly patients with the Wolf-Parkinson-White syndrome should be managed as aggressively as their younger counterparts. In particular, manifestation of arrhythmias due to Wolff-Parkinson-White syndrome beyond age 30 should not be regarded as a more benign variation of the syndrome. Explanations for the more frequent history of resuscitation in the elderly include the presence of organic heart disease with impairment of left or right ventricular function and differences in the management of these patients.
为研究预激综合征与年龄相关的差异，将20例年龄在40 - 65岁的老年患者与26例年龄在18 - 39岁的年轻患者进行比较，观察其临床特征和电生理特性。两组在折返性心动过速机制、旁路位置、报告晕厥发作的患者数量以及诱发和/或记录到的心房扑动/颤动发生率方面具有可比性，而仅老年患者还存在房性心动过速。老年组的特点是相关器质性心脏病的发生率较高，循环骤停复苏成功的比例显著更高。心律失常导致的心脏循环骤停是30%老年患者转入我院的原因，而年轻组这一比例为7.7%。根据快速心律失常出现时的年龄（<30岁、≥30岁）进行分层时，也得到了类似结果，两组之间唯一的显著差异是心肺复苏史。两个年龄组之间或心律失常出现时的年龄方面，任何电生理参数均无差异。结论是，预激综合征老年患者应与年轻患者一样积极治疗。特别是，30岁以后因预激综合征出现的心律失常不应被视为该综合征的一种更良性的变异。老年患者复苏史更频繁的原因包括存在影响左心室或右心室功能的器质性心脏病以及这些患者治疗方式的差异。
