Too often, tachycardias of elderly patients are medically treated without evaluation of their mechanism. The purpose of the study was to look for the influence of age on clinical and electrophysiological data and long-term follow-up of patients with paroxysmal supraventricular tachycardia (SVT).

SVT was induced in 1690 patients, 996 females, mean age 49±19 years referred for regular tachycardia. Clinical history, SVT-related complications, echocardiography, results of electrophysiological study, methods of treatment were collected.

269 patients with SVT were aged from 70 to 97 years (group I),188 from 70 to 79 (group IA) and 81 from 80 to 97 (group IB). Anticoagulants were prescribed in 23 for an erroneous diagnosis of atrial tachycardia. They were compared to 1421 patients <70 years (group II). Heart disease was more frequent in group I (26%) (group IA:30%, group IB:18%) than in group II (9%) (p<0.0001). Atypical and typical AV node reentrant tachycardia were more frequent in group I (94%) than in group II (80%) and concealed accessory pathway was less frequent in group I (6%, Group IA:7%, IB:5%) than in group II (20%). SVT-related adverse events were more frequent in group I (26%) (p<0.0001) (group IA:25%, group IB:29%) than in group II (11%). During follow-up (3±3 years), SVT ablation was indicated more frequently in group I (73%) (p<0.002) (group IA:73%, group IB:72%) than in group II (62.5%). SVT ablation-related complications were more frequent in group IB:7%) (p<0.011) than in group I (3.5%) or IA (4%). Late occurrence of atrial fibrillation (AF) was more frequent in group IA (10%) than in group II (5%) (p<0.04) (NS for the group IB (5%). Cardiac deaths were more frequent in group I (6%) (group IA:4%, group IB: 7.5%) than in group II (2%) (p<0.001).

SVT-related adverse presentation was frequent in elderly patients. We recommend the evaluation of regular SVT’s because they can be related to AVNRT/AVRT. Curative treatment of these tachycardias can be done despite a risk of ablation-related major complications more frequent after 79 years and a risk of AF development and cardiac death higher in elderly patients than in younger patients.