[Evaluation of heart rate changes in the aged. An ambulatory electrocardiography study. Arrhythmias in the aged]
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Cardiac arrhythmias are common in older adults, regardless of cardiovascular disease. Holter monitoring revealed frequent supraventricular and ventricular arrhythmias in the elderly, with unclear clinical significance.
Area of Science:
- Cardiology
- Geriatrics
- Electrophysiology
Background:
- Cardiac arrhythmias are prevalent in the aging population.
- The clinical significance of these arrhythmias in the elderly, particularly those without overt cardiovascular disease, requires further investigation.
Purpose of the Study:
- To assess the clinical significance of cardiac arrhythmias in individuals over 65 years old.
- To investigate the prevalence of various arrhythmias in relation to cardiovascular health status in the geriatric population.
Main Methods:
- Conducted Holter examinations (dynamic ECG) on 111 subjects aged over 65.
- Evaluated Holter recordings based on current guidelines, analyzing basic rhythm, heart rate, conduction disturbances, and supraventricular/ventricular arrhythmias.
- Categorized subjects into three groups: no cardiovascular disease (Group A), ischemic cardiomyopathy (Group B), and arterial hypertension (Group C).
Main Results:
- Sinus rhythm was the predominant basic rhythm across all groups.
- Atrial fibrillation occurred at similar rates in all three groups, irrespective of cardiovascular disease presence.
- Supraventricular and ventricular hyperkinetic arrhythmias, including ventricular tachycardia, were common in the elderly and did not differ significantly between healthy individuals and those with cardiovascular conditions.
Conclusions:
- Cardiac arrhythmias are highly prevalent in the elderly population.
- The presence of common arrhythmias like atrial fibrillation and ventricular tachycardia in geriatric patients does not strongly correlate with underlying cardiovascular disease.
- The clinical significance of observed heart rhythm changes in the elderly remains largely undetermined due to their frequent lack of association with diagnosed cardiovascular conditions.
Abstract:
The Holter examinations of 111 subjects aged more than 65 who then underwent dynamic ecg were investigated in order to assess the clinical significance of cardiac arrhythmias in geriatric age. Group A was formed of 53 patients with no clinical signs of cardiovascular diseases. Thirty-two patients with clinical evidence of ischaemic cardiopathy made up Group B and 26 with arterial hypertension formed Group C. The Holter examinations were evaluated in accordance with current guidelines, considering the basic rhythm, heart rate, pulse formation and conduction disturbances and supraventricular and ventricular hyperkinetic arrhythmias. Sinus base rhythm was present in most cases whereas atrial fibrillation was noted in a similar percentage in the three groups, whether or not cardiovascular disease was present. Supraventricular and ventricular hyperkinetic arrhythmias were extremely common in the elderly and made no discrimination between patients with ischaemic cardiopathy or hypertension and the clinically healthy; for example, ventricular tachycardia was observed in 10.6% of Group A subjects, in 7.1% of Group B and 8.6% of Group C. To conclude, the clinical significance of heart rhythm changes in the elderly remains obscure because in most subjects they are not related to the presence of cardiovascular disease.