[Changes in the electrocardiogram in the elderly patient. The limits between normality and pathology]

Area of Science:

• Cardiology
• Geriatrics
• Electrocardiography

Background:

• Normal electrocardiographic (ECG) criteria in the elderly are not well-defined.
• The prevalence of ECG abnormalities significantly increases with advanced age.
• Aging impacts cardiac electrical activity, necessitating age-specific interpretation guidelines.

Purpose of the Study:

• To define normal electrocardiographic criteria in the elderly population.
• To determine the prevalence of various electrocardiographic abnormalities in different age groups of the elderly.
• To analyze age-related changes in cardiac electrical activity.

Main Methods:

• Review and synthesis of existing literature on electrocardiographic findings in elderly populations.
• Analysis of prevalence data for specific ECG abnormalities across different age strata (e.g., 65-69, >70, >85, >90 years).
• Inclusion of data from hospitalized elderly patients for comparison.

Main Results:

• Prevalence of ECG abnormalities is three times higher in individuals over 85 compared to those aged 65-69.
• Common findings include sinus pauses (especially nocturnally), first-degree atrioventricular block (8.1%-19%), left anterior hemiblock (11% over 70), and bundle branch blocks.
• Atrial fibrillation prevalence increases with age, reaching 27% in hospitalized individuals over 90; ventricular ectopic contractions are highly prevalent (76%-96%).

Conclusions:

• Electrocardiographic abnormalities are a common feature of aging, with prevalence increasing significantly in advanced age.
• Specific conditions like atrial fibrillation, various heart blocks, and ectopic beats require careful consideration in geriatric ECG interpretation.
• Further research is needed to establish definitive normal ECG criteria for the elderly.