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Europace 2001 3(3):216-220; doi:10.1053/eupc.2001.0175
© 2001 by European Society of Cardiology
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ELECTROPHYSIOLOGY

Electrophysiological properties of the atrioventricular node and ageing: evidence of a lower incidence of dual nodal pathways in the elderly

Daniele D'Este, Emanuele Bertaglia, Albino Zanocco, Bernhard Reimers and Pietro Pascotto

Cardiology Department Ospedale Civile, Mirano (Venice), Italy

Abstract

AIMS: The purpose of this study was to investigate the relationship between the incidence of dual atrioventricular (AV) nodal pathways and age. Age-related changes in the AV node electrophysiological properties have rarely been investigated. AV nodal re-entrant tachycardia is more frequent in the young than in the elderly.

METHODS AND RESULTS: From 1988 to 1998, premature atrial stimulation was performed in 1435 patients referred to our institution for transoesophageal electrophysiological study. 1276 patients (89%) with a diagnosis of ventricular pre-excitation, supraventricular arrhythmia or AV block were excluded. The study cohort consisted of the remaining 159 patients (11% of the whole group) referred for syncope (8·2% of the subgroup), suspected ventricular pre-excitation (10·7%), suspected sinus node dysfunction (52·8%) or undetermined palpitations (28·3%). The 159 study patients were divided into 3 groups according to age: group A (11–30 years, 50 patients), group B (30–60 years, 35 patients) and group C (>60 years, 74 patients).

A dual AV nodal pathway was found in 16 patients of group A (32·0%), 6 patients of group B (17·1%) and 8 patients of group C (10·8%), the difference between group A and group C being significant (P< 0·05).

CONCLUSION: The incidence of dual AV nodal pathways decreases with ageing, suggesting that the AV node undergoes age-related electrophysiological changes. This finding could explain the uncommon onset of AV nodal re-entrant tachycardia in the elderly.

Key Words: Atrioventricular node, atrioventricular nodal re-entrant tachycardia, ageing

Correspondence: Daniele D'Este, Divisione di Cardiologia, O.C. Mirano, via Mariutto, 14-30035 Mirano (Venice), Italy. E-mail: ulss13mir.card{at}tin.it


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