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Late onset atrioventricular nodal tachycardia
M L Pentinga1, J G Meeder, H J Crijns
1Department of Cardiology, University Hospital Groningen, The Netherlands.
International Journal of Cardiology
|March 1, 1993
Summary
Late onset AV nodal tachycardia, occurring after age 45, is not uncommon. Underlying heart disease and frequent supraventricular arrhythmias may contribute to its development in older adults.
Area of Science:
- Cardiology
- Electrophysiology
- Geriatric Medicine
Background:
- Atrioventricular (AV) nodal tachycardia typically presents earlier in life.
- Late adult onset of AV nodal tachycardia is considered unusual, prompting investigation into potential underlying causes.
Purpose of the Study:
- To investigate the relationship between late-onset AV nodal tachycardia and organic heart disease.
- To explore factors contributing to the development of AV nodal tachycardia in older individuals.
Main Methods:
- Studied 32 consecutive patients with symptomatic AV nodal tachycardia.
- Analyzed age at onset, presence of underlying heart disease, and supraventricular ectopic activity via 24-h ambulatory monitoring.
Main Results:
- A bimodal age distribution of onset was observed, with peaks in young adulthood and around age 55.
- Older patients (≥45 years) were significantly more likely to have underlying heart disease (60% vs. 14%).
- Frequent supraventricular ectopic activity was more prevalent in older patients (100% vs. 50%).
Conclusions:
- Late-onset AV nodal tachycardia (onset >45 years) represents a significant proportion (33%) of cases.
- Age-related structural changes in the AV node, potentially exacerbated by heart disease, may facilitate re-entrant circuits.
- Frequent supraventricular arrhythmias and underlying cardiac conditions are implicated in the pathogenesis of late-onset AV nodal tachycardia.