Epidemiology of Arrhythmias and Conduction Disorders in Older Adults

Abstract

Normal aging is associated with a multitude of changes in the cardiovascular system, including decreased compliance of blood vessels, mild concentric left ventricular hypertrophy, an increased contribution of atrial contraction to left ventricular filling, and a higher incidence of many cardiac arrhythmias, both bradyarrhythmias and tachyarrhythmias. Conduction disorders also become more common with age, and may either be asymptomatic, or cause hemodynamic changes requiring treatment. The epidemiology of common arrhythmias and conduction disorders in the elderly is reviewed.

Should All Patients With Heart Block Receive Biventricular Pacing?

“…Approximately 1% to 2% of normal subjects have first-degree AVB which increases to 5% in men over the age of 60 with cardiac diseases. [8][9][10] The prevalence of second-degree AVB for Mobitz II block is estimated to be 3% in patients with HF, and it is estimated that 5% to 10% of people will develop a third-degree heart block in those >70 years old and having a history of heart disease. 8 In clinical practice, decisions for pacemaker implantation are determined by symptoms and pacing indications as in the guidelines which are based on expert opinion from experience because there is no other effective treatment for bradycardia and no major randomized trials.…”

Understanding the ECG Part 4: Conduction blocks

“…On the ECG, the effects of AV block can be seen in changes in the PR interval, in P-waves that are not followed by QRS complexes, or in complete electrical dissociation of the atria and ventricles (Hampton, 2013). Based on the degree of conduction block, AV blocks are classified as first-, second-or third-degree in nature (Chow et al, 2012).…”

“…The cardiac conduction system is subject to the same disease processes that impair the function of other parts of the heart, and the result is a range of conduction disturbances (Chow et al, 2012). Impulses from the sinus node may fail to conduct through the atria, may be delayed in their journey through the conduction system, or may fail to arrive in the ventricles at all.…”

Antiarrhythmic drugs use in elderly patients. Vaughan Williams class I and II drugs

“…При целенаправленном скрининге желудочковые аритмии обнаруживаются у 70-80% пациентов старше 60 лет, хотя во многих случаях остаются бессимптомны-ми [7][8], фибрилляция предсердий -менее чем у 1% лиц моложе 60 лет и у 9-17,6 % -старше 80 лет [9][10][11]. Бо-лее 80% внезапных сердечных смертей возникает у лиц старше 65 лет [12].…”