Nghiên cứu đặc điểm lâm sàng và điện sinh lý tim nhịp nhanh kịch phát trên thất ở người cao tuổi tại Bệnh viện Đại học Y Dược thành phố Hồ Chí Minh=Clinical features and electrophysiology characteristics of supraventricular tachycardia in the elderly in university medical center at Ho Chi Minh city

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Tác giả: Vạn Phước Đặng, Cao Sơn Lương, Thất Minh Tôn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.125-132

Bộ sưu tập: Metadata

ID: 477707

Thêm vào giỏ

Atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia and atrial tachycardia are the most popular types of supraventricular tachycardia (SVTs). These are common arrhythmias in practice with various clinical features especially in the elderly. Therefore, an electrophysiology study is critical to identify the diagnosis and treatment if medications do not work. However, the study is deficient of in this problem. Objectives: To describe the clinical features and electrophysiology of SVTs in the elderly compared to the youngers. Subjects and methods: A consecutive study including 107 patients over 60 years old and 302 younger ones. They were studied in the EP lab in university medical center from 1/2017 to 12/2020.Results: 67.2% were AVNRT and the others were AVRT (manifest and concealed pathways). The most prevalent symptoms were fatigue (86%), palpitation (82.2%), and chest discomfort (27.1%), syncope and hypotension 4.7% and 7.5% respectively. In the AVNRT group, elderly patients showed a longer basic cycle length, AH interval, effective refractory period of orthodromic atrioventricular nodal, and slow and fast pathways compared to the young group. On the contrary, in the AVRT group, both tachycardia cycle length and AH interval of the elderly were longer than the under 60 y.o group. Conclusion: SVTs express diverse clinical features in the elderly. Many electrophysiology characteristics were significantly different from the younger ones.Nhịp nhanh kịch phát trên thất (NNKPTT) bao gồm nhịp nhanh vào lại nút nhĩ thất (NNVLNNT), nhịp nhanh vào lại nhĩ thất (NNVLNT) và nhịp nhanh nhĩ. Đây là những rối loạn nhịp thường gặp với biểu hiện lâm sàng đa dạng và cần thăm dò điện sinh lý trong buồng tim để xác định cơ chế chính xác. Những dữ liệu này chưa được nghiên cứu nhiều ở người cao tuổi. Mục tiêu: Mô tả biểu hiện lâm sàng và điện sinh lý tim NNKPTT ở người cao tuổi so sánh với nhóm trẻ tuổi. Đối tượng và phương pháp nghiên cứu: Nghiên cứu cắt ngang mô tả theo trình tự thời gian. Gồm 107 BN ≥60 tuổi và 302 BN <
60 tuổi được khảo sát điện sinh lý tim tại Bệnh viện Đại học Y dược TP.HCM từ 1/2017 đến 12/2020. Kết quả: 67,2% BN NNVLNNT và 32,8% NNVLNT. Triệu chứng lâm sàng thường gặp nhất là mệt (86%), hồi hộp (82,2%) và nặng ngực (27,1%), ngất và tụt huyết áp là 4,7% và 7,5%. Đối với NNVLNNT, người cao tuổi có độ dài chu kì cơ bản, khoảng AH, thời gian trơ hiệu quả của nút nhĩ thất chiều xuôi, thời gian trơ của đường nhanh và đường chậm của nút nhĩ thất, điểm mất dẫn truyền xuôi 1:1 qua nút nhĩ thất dài hơn so với nhóm trẻ. Đối với NNVLNT, độ dài chu kì nhịp nhanh và khoảng AH ở nhóm BN ≥60 tuổi dài hơn so với nhóm BN <
60 tuổi. Kết luận: Nhịp nhanh kịch phát trên thất ở người cao tuổi có biểu hiển lâm sàng đa dạng và một số đặc điểm điện sinh lý tim khác biệt so với người trẻ.

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