[Normal electrocardiogram in the aged (the ILSA (Italian Longitudinal Study of Aging) Project)]

The ILSA project (Italian Longitudinal Study of Aging) involved acquiring and storing ECG signals and basic clinical-instrumental data via computerized techniques. This database represents the first opportunity to analyze the ECGs of the elderly in Italy and compared a significant sample of the entire Italian population between the ages of 65 and 84. Thus, the study included 88 male subjects and 88 female subjects from four age groups (65-69, 70-74, 75-79, 80-84), for a total of 5632 people. The characteristics of a group of "healthy" patients without any cardiovascular disease were defined using clinical ECG-independent data. After excluding records characterized by an altered morphology (QRS of over 120 ms, confirmed necrotic Q waves in at least two specific leads, confirmed ventricular hypertrophy), a group of 698 "healthy" patients with "normal" ECGs was selected. The mean and standard deviation of the traditional electrocardiographic parameters were evaluated for this group. In agreement with the results of similar studies performed on non-Italian populations, the following conclusions can be drawn: P-wave axis and duration show similar values with respect to the "normal" limits of the adult population; the QRS duration does not show significant changes with age, whereas the QRS axis shifts leftward as age increases; as compared with traditional ranges, the PQ interval is slightly higher than values computed at the corresponding frequency; QT-interval has similar values in the same heart rate interval. The debate on the clinical relevance and meaning of the presence of undoubtedly pathological ECGs in the elderly without any declared or evident pathology still open remains to be settled.