Cardiac arrhythmias associated with upper gastrointestinal endoscopy in elderly subjects

Continuous Holter monitoring was performed before, during and after upper gastrointestinal endoscopy in 50 unselected, consecutive elderly patients (median age 80 years: range 68-89). In contrast to other studies the patients received no atropine or opiate premedication and were monitored for a prolonged period usually 24 hours after endoscopy. Comparison of a control period when the patient was lying at rest before endoscopy with the period of endoscopy itself revealed an increased frequency of arrhythmias during endoscopy. Forty-eight per cent of patients developed a new arrhythmia or an increased frequency of existing arrhythmia during endoscopy. All arrhythmias were short and self-terminating. Evidence of cardiac disease conferred a significantly increased risk of developing an arrhythmia during endoscopy.