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[Cardiac arrhythmias in active elderly persons--age dependence of heart rate and arrhythmias]
Insights
Heart rate and arrhythmias in active elderly individuals show age-related changes, with increased complex ventricular arrhythmias but no increased mortality. This study compares cardiac findings in older adults versus younger subjects.
Area of Science:
- Cardiology
- Gerontology
- Electrophysiology
Context:
- Cardiac function and rhythmicity undergo significant changes with aging.
- Understanding age-related cardiac alterations is crucial for geriatric health.
- Previous research has focused on pathological conditions, leaving normal age-related changes less defined.
Purpose:
- To investigate and compare heart rate patterns and arrhythmias in active elderly individuals versus younger asymptomatic adults.
- To identify age-specific trends in cardiac electrical activity and rhythm disturbances.
- To assess the prevalence of various arrhythmias, including supraventricular and ventricular premature beats, atrial fibrillation, and conduction blocks, across different age groups.
Summary:
- Active elderly individuals (mean age 79.5 yrs) exhibited lower maximal heart rates but higher minimal and nocturnal heart rates compared to younger subjects (mean age 34.8 yrs).
- While supraventricular premature beats frequency was similar, complex forms were more common in the elderly. Ventricular arrhythmias, including frequent and complex forms, were significantly more prevalent in the elderly group.
- Bradycardias and AV-blocks showed no significant age-related difference, but right bundle branch block was exclusive to the elderly. Permanent atrial fibrillation increased in incidence in the very old (90-102 yrs).
- No increase in mortality was linked to arrhythmias during a seven-year follow-up period.
Impact:
- Provides normative data on cardiac rhythm and heart rate variability in active aging populations.
- Highlights the increased prevalence of complex ventricular arrhythmias in the elderly, necessitating careful clinical evaluation.
- Suggests that many observed arrhythmias in the elderly may be benign, as evidenced by the lack of increased mortality in this study.
- Informs clinical practice regarding the interpretation of electrocardiographic findings in older adults.
Abstract:
Arrhythmias and heart rate of 82 active elderly persons (mean age 79.5 yrs) were registered by 24-hour electrocardiographic recording and compared with the results of 100 asymptomatic subjects (age 34.8 yrs). In each decade 10 men and 10 women were included. Maximal heart rate was lower in old age but over 100 bpm. Minimal and nocturnal heart rates showed a steady rise with increasing age. The mean 24-hour heart rate was higher in middle-aged females than in males, whereas in the elderly no sex-related difference was observed. Sinus arrhythmia, wandering pacemaker, short lengthening of RR-intervals prevailed in younger persons. Short sinus-tachycardias in the late night were equally frequent in both groups. The frequency of supraventricular premature beats did not differ between the two groups (85.4 vs. 76%). However, high intraindividual numbers and more complex forms were more frequent in the elderly. Paroxysmal atrial fibrillation was never registered. Permanent atrial fibrillation occurred in 41% of the subjects being between 90 and 102 years of age. Ventricular arrhythmias were age-related: 87.2% of the elderly vs. 50% of the middle-age subjects had ventricular premature beats, predominantly frequent and complex forms. A significant age relation to bradycardias could not be observed: Sinus pauses over 2000 ms (11 vs. 17%), first and second degree AV-block (22 vs. 21%) occurred equally frequent in both groups. An intermittent short third degree AV-block was observed in a man 84 years old who was asymptomatic. Right bundle branch block was present only in the elderly (6.1%). No arrhythmia-related increase of mortality was observed during a seven-year follow-up.