# Supraventricular Tachycardia Ablation in the Elderly—Characteristics and Outcomes

## TL;DR

The study shows that SVT ablation is safe and effective for elderly patients, with similar success and complication rates as younger patients.

## Contribution

The study provides robust data on SVT ablation outcomes specifically in elderly patients, a group underrepresented in prior research.

## Key findings

- Elderly patients had higher rates of AVNRT and structural heart disease compared to younger patients.
- Procedure times were shorter for elderly patients, but success and complication rates were similar.
- SVT ablation is safe and effective in elderly patients, supporting its use regardless of age.

## Abstract

Catheter ablation is an effective treatment for symptomatic supraventricular tachycardia (SVT). Most studies target the general adult population; data on the elderly are less robust. We studied the clinical and procedural characteristics and outcomes in elderly patients undergoing SVT ablation.

All patients undergoing atrioventricular nodal re‐entry tachycardia (AVNRT), atrioventricular re‐entry tachycardia (AVRT), and/or atrial tachycardia (AT) ablation between May 2011 and May 2022 at a tertiary center were included. Cases with concurrent ablation of atrial flutter, atrial fibrillation, and ventricular arrhythmias were excluded. Clinical and procedural characteristics and outcomes were compared between patients aged ≥ 70 years and those aged < 70 years.

There were 1758 cases of SVT ablation; 1608 patients were < 70 years old, and 150 patients were ≥ 70 years old. Elderly patients were more likely to have underlying structural heart disease and/or ischemic heart disease, more likely to have AVNRT and less likely to have AVRT (p < 0.001). Consequently, elderly patients were more likely to undergo right‐sided ablation (p < 0.001). The use of stereotaxis, intracardiac echocardiography, and electroanatomical mapping did not differ significantly. Procedure time, radiofrequency application time and fluoroscopy time were shorter in elderly patients (p < 0.05). Importantly, immediate complication and success rates did not differ significantly.

In our study, the acute success rates are high, and complication rates are low across both cohorts despite differences in clinical and procedural characteristics. SVT ablation should be considered for symptomatic patients regardless of age. Further data including patient comorbidities and longer‐term outcomes may help patient selection.

This single‐center retrospective study found that supraventricular tachycardia (SVT) ablation is safe and effective in younger and elderly patients. It should be considered for all symptomatic individuals regardless of age. However, the type of SVT and the presence of comorbidities, including frailty, should be considered in the clinical decision‐making process.