Findings on ambulatory electrocardiographic monitoring in subjects older than 80 years

Kantelip, Jean-Pierre; Sage, Évelyne; Duchêne-Marullaz, P

doi:10.1016/0002-9149(86)90760-5

Cited by 104 publications

(42 citation statements)

References 13 publications

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“…In addition, the interpretation of findings with this test can be difficult, since the frequency of asymptomatic arrhythmias increases with age [1,5]. For instance, the prevalence of supraventricular and ventricular extrasystoles is reported to be greater than 80% in the population of over 65 year olds [6,7]. The difficulty in interpretation of 24-hour Holter tapes arises, therefore, because of a lack of specific criteria for defining clinically important arrhythmias [8].…”

Section: Discussionmentioning

confidence: 99%

Suspected Cardiac Syncope in Elderly Patients: Use of the 12-Lead Electrocardiogram to Select Patients for Holter Monitoring

Manchanda

Ehsanullah

2001

Gerontology

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Background: Results of 24-hour Holter monitoring in elderly patients are often unhelpful, since the prevalence of asymptomatic arrhythmias increases and their prognostic significance is unclear. We investigated the value of the resting electrocardiogram (ECG) in predicting significant findings on 24-hour Holter recordings in those suspected of having cardiac syncope. Objective: To see whether the resting 12-lead ECG can be used as a screening tool to select elderly patients suspected of having cardiac syncope for 24-hour ECG monitoring. Method: Comparison of resting 12-lead ECGs and 24-hour Holter tapes in 145 consecutive elderly outpatients suspected of having a cardiac cause for falls, dizziness, or syncope. Results: Four of 30 normal ECGs (13%) showed an abnormality on Holter monitoring as compared with 55 of the 115 abnormal ECGs (47.8%; chi = 11.7143, p < 0.005). In the ‘normal’ group the 4 abnormal Holter recordings all showed short runs of supraventricular tachycardia, and no intervention resulted. The 115 abnormal resting ECGs showed either ischaemia (n = 27), dysrhythmia (n = 28), sinus bradycardia (n = 22), or conduction defects (n = 38). The 55 of these which showed abnormalities on Holter recordings occurred mostly where the resting ECG showed dysrhythmia (n = 14/28; 50%), bradycardia (n = 19/22; 86.4%), and conduction defect (n = 17/38; 44.7%). Seven patients had complete heart block on Holter, and all had conduction defects on resting ECG (p < 0.0004). Fifteen patients had pauses of longer than 3 s on Holter; all had conduction defect, bradycardia, or dysrhythmias on resting ECG (p < 0.0045). Sixteen patients were paced because of complete heart block or pauses on Holter recordings, and all had either bradycardia or conduction defects on resting ECG, resulting in complete resolution of their symptoms. Conclusions: Patients with suspected cardiac syncope and normal resting ECGs are unlikely to reveal significant abnormalities on single 24-hour Holter monitoring. Cardiac event recorder or prolonged Holter monitoring may be required in patients with strong clinical history. Those with abnormal ECGs, in particular sinus bradycardia and conduction defects, are highly likely to have significant abnormalities on 24-hour ECG monitoring.

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Section: Discussionmentioning

confidence: 99%

Suspected Cardiac Syncope in Elderly Patients: Use of the 12-Lead Electrocardiogram to Select Patients for Holter Monitoring

Manchanda

Ehsanullah

2001

Gerontology

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“…From a clinical point of view, patients were included in the study if they fulfilled one of the following criteria in association with a positive complement fixation test for Chagas' disease: (1) right bundle branch block associated or not with left anterior hemiblock even though no other clinical or radiological abnormality was observed, as these ECG changes are strongly sug gestive of Chagas' disease in endemic areas [8][9][10][11]; (2) enlargement of the cardiac silhouette in the chest X ray even though congestive heart failure or the elec trocardiographic changes outlined above were not de tected, and (3) mild, moderate or severe congestive heart failure, according to the New York Heart Asso ciation classification [12]. O f the initial 38 patients, 13 were excluded from the study for the following reasons: 2 had a cerebrovascular hemorrhagic acci dent probably due to severe arterial hypertension, 1 had acute myocardial infarction, and 3 showed non specific ECG changes commonly found in elderly patients (atrial fibrillation, low-voltage QRS complex, atrial and ventricular premature contractions) [13] but a normal cardiac silhouette with no congestive heart failure. Only the 2 patients who suffered a cere brovascular accident died.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, intraventricular conduction defects are found at higher fre quency than in other types of cardiomyopathy [16]. Nevertheless, ventricular premature contractions, left anterior hemiblock, atrial fibrillation and pathological Q waves are com monly observed in the ECG of nonchagasic elderly patients [ 13,[22][23][24]. In contrast, right bundle block alone and associated with left anterior hemiblock is more frequent in elderly patients with Chagas' disease than in the gen eral elderly population [7], The ECG tracings recorded in this study showed the same alter ations, and the same frequency of occurrence as those detected in middle-aged patients with chronic Chagas' heart disease.…”

Section: Clinical Findingsmentioning

confidence: 99%

Chronic Chagas’ Heart Disease in the Elderly: A Clinicopathologic Study

Bestetti¹,

Ramos²,

Godoy³

et al. 1987

Cardiology

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A retrospective study of the medical records of our hospital from 1965 to 1985 was carried out to characterize for the first time chronic Chagas’ heart disease in the elderly (more than 70 years old). A total of 25 patients (mean age = 76) were suitable for the study. Congestive heart failure, sudden cardiac death, thromboembolism and atypical chest pain were found in 68, 16, 8 and 8% of cases, respectively. Ventricular premature contractions (60%), right bundle branch block (32%), left anterior hemiblock (28%), atrial fibrillation (28%) and right bundle branch block associated with left anterior hemiblock (20%) were the ECG changes most frequently found. A morphological study was performed on 8 (32%) patients. All of them showed cardiac abnormalities, with apical aneurism being detected in 100% of cases. At autopsy, pulmonary embolism was observed in 3 (37%) of these patients who presented with congestive heart failure, ventricular premature contractions and/or intraventricular conduction defect and/or atrial fibrillation. Thus, the characteristics of chronic Chagas’ heart disease in the elderly are similar to those found in middle-aged patients. We suggest that these patients are important for the study of the pathogenesis of chronic Chagas’ heart disease because they may have less aggressive pathophysiologic mechanisms than middle-aged patients.

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“…Existing studies in this field on elderly patient populations cover broad age ranges, but with few patients over 90 years [1,2,5,6]. The aim of the present study was to ana lyze cardiac rhythm in the very elderly (> 90 years).…”

Section: Introductionmentioning

confidence: 99%

Twenty-Four-Hour Electrocardiographic Study in the Active Very Elderly

Rossi¹

1987

Cardiology

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Cardiac rhythm was studied by means of 24-hour ambulatory ECG in 18 active outpatients, mean age 92.3 ± 2.3 years. The main characteristics observed were the following: a broad dynamic heart rate range; relatively rare atrial fibrillation (5.5%); incidence of simple atrial and ventricular premature beats, complex atrial premature beats or supraventricular tachycardia in all subjects, while ventricular tachycardia and R-on-T phenomenon were present in only one subject. The ‘arrhythmic normality’ parameters in the very elderly probably need to be revised, and only severe ventricular arrhythmias appear to be an abnormal phenomenon.

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Findings on ambulatory electrocardiographic monitoring in subjects older than 80 years

Cited by 104 publications

References 13 publications

Suspected Cardiac Syncope in Elderly Patients: Use of the 12-Lead Electrocardiogram to Select Patients for Holter Monitoring

Suspected Cardiac Syncope in Elderly Patients: Use of the 12-Lead Electrocardiogram to Select Patients for Holter Monitoring

Chronic Chagas’ Heart Disease in the Elderly: A Clinicopathologic Study

Twenty-Four-Hour Electrocardiographic Study in the Active Very Elderly

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Findings on ambulatory electrocardiographic monitoring in subjects older than 80 years

Cited by 104 publications

References 13 publications

Suspected Cardiac Syncope in Elderly Patients: Use of the 12-Lead Electrocardiogram to Select Patients for Holter Monitoring

Suspected Cardiac Syncope in Elderly Patients: Use of the 12-Lead Electrocardiogram to Select Patients for Holter Monitoring

Chronic Chagas&rsquo; Heart Disease in the Elderly: A Clinicopathologic Study

Twenty-Four-Hour Electrocardiographic Study in the Active Very Elderly

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Chronic Chagas’ Heart Disease in the Elderly: A Clinicopathologic Study