ABSTRACT
BACKGROUND: Coronary intervention is one of well established therapeutic modalities for patients with ischemic heart diseases. With the prolonged life expectancy and changes in dietary habits in Korea, the number and percentage of elderly patients with ischemic heart disease have increased in interventional coronary therapies. METHOD: There were 1762 patients (age> or = 70 years : 253, age<70 years: 1509) who underwent diagnostic coronary angiogram at Chonnam University Hospital between Jan '96 and Jun '97. We compared clinical characteristics, coronary lesion morphology, success rates and complications of coronary interventions in control and aged groups. RESULTS: 1) Female patients were more prevalent in aged group (43 %; 145 male, 108 female) than in the control group (35%; 982 male, 527 female, p<0.05). 2) The diagnostic sensitivity of coronary angiogram was higher in the aged (169/253, 67 %) than in control group (738/1509, 49 %, p<0.05). Multivessel diseases were more prevalent in the aged (65 %) than in the control groups (49%). 3) Coronary interventions were performed less frequently in the aged group (119/169, 70 %) than in the control group (605/738, 82%, p<0.05). The success rates of PTCA were not different between in the aged (89%) and control (93%) groups, and the success rates in stenting was also not different between the aged (98%) and control (99%) groups. 4) Procedure-related complications (4.6 vs. 7.6 %) and mortalities (0.5 vs 0.8 %) during and after coronary interventions were not different in control and elderly groups. CONCLUSION: Coronary interventions in patients older than 70 years can be performed with high success and low complication rates ; the results do not differ from those of younger patients.
Subject(s)
Aged , Female , Humans , Male , Feeding Behavior , Korea , Life Expectancy , Mortality , Myocardial Ischemia , StentsABSTRACT
OBJECTIVES: Accurate diagnosis of the mechanism and origin site of paroxysmal supraventricular tachycardia(PSVT) can be made using electrophysiologic study(EPS). Recently, radiofrequency catheter ablation technique has been introduced and widely used for the definitive treatment of various forms of PSVT, thereby precise determination of the mechanism of PSVT can be possible. It has been known that atrioventricular reentry tachycardia (AVRT) using concealed bypass tract is more frequent than atrioventricular nodal reentry tachycardia (AVNRT) in Korea. But it is not certain that those studies represent actual distribution of PSVT in Korea. This study was designed to determine the mechanism and clinical characteristics of PSVT in Korea. METHODS: We investigated 136patients in whom electrophysiolosic study was performed from October 1992 through October 1994 at the Chonnam National University Hospital, the only tertiary referral center of the Kwangju-Chonnam area of Korea. RESULTS: 1) The electrophysiologic mechanism of PSVT was AVNRT in 44patients(32.4%), WPW syndrome in 46(33.8%), AVRT using concealed bypass tract in 40(29.4%), sinoatrial nodal reentry tachycardia (SANRT) in 4(2.9%), and automatic atrial tachycardia(AAT) in 2(1.5%), ensuing that AVNRT is most common mechanism of PSVT with no preexcitation during sinus rhythm. 2) Male is more frequent than female in AVNRT, WPW syndrome, and AVRT, which was most prominent in WPW syndrome. 3) The first episode of symptom occured at the age of 34.9 +/- 17.3 years in AVNRT, 25.5 +/- 13.3 years in WPW and 26.3 +/- 15.0 years in AVRT(p<0.05). There was no significant difference in the duration of symptom. The tachycardia rate in WPW syndrome was 183.6 +/- 23.9 per minute and AVRT was 186.7 +/- 38.0 per minute, which were faster than that of AVNRT(161.7 +/- 28.6/min)(p<0.05). 4) There was no significant difference in the presenting symptoms and in the provocation factors between AVNRT and AVRT. CONCLUSION: AVNIlT is most common mechanism of PSVT with no preexcitation during sinus rhythm, developed at older age than WPW syndorme and AVRT, and had lower tachycardia rate than WPW syndrome and AVRT.