Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

Abstract

PurposeWith longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged ≥66 years. We also investigated the feasibility of wireless long-term recording (LTR) using the ECG-BodyKom®.MethodsTwo hundred elderly persons aged 66–93 years were recruited from the Swedish National Study on Aging and Care in 2010–2013, and data were collected via wireless LTR ECG-BodyKom.ResultsScreening with the LTR ECG revealed that persistent atrial fibrillation (AF) occurred in 10% of the outpatient population aged ≥66 years. Paroxysmal AF occurred in 5.5% of the population, with no difference between younger (60–80 years) and older (>80 years) elderly participants. Furthermore, all patients with paroxysmal AF had a CHA2DS2VASc score of ≥2 and were therefore potential candidates for follow-up and medical examination. LTR ECG-BodyKom can be considered a feasible method to screen for arrhythmias in older outpatient populations. This simple method requires little of the user, and there was high satisfaction with the equipment and a good overall experience wearing it.ConclusionThe increasing occurrence of arrhythmias in the older population, as well as the high number of untreated cases of arrhythmias such as persistent AF and paroxysmal AF, poses a challenge for health care. Therefore, it is essential to develop effective strategies for their prevention and treatment.

Electrocardiographic abnormalities in elderly patients interned in the Medical Clinic Service of the Hospital Nacional in 2018

“…los sujetos mayores de esta edad, en 14% en 85 años y en 27% de pacientes hospitalizados o institucionalizados mayores de 90 años (8,9) . La prevalencia de contracciones ectópicas ventriculares varía del 76% en los estudios realizados con ECG basal al 96% en los estudios realizados con ECG de monitorización portátil.…”

“…En pacientes con más de 65 años, la fibrilación auricular se observa en el 4,8% de las mujeres y el 6,2% de los hombres. Estas diferencias de sexo puede estar relacionado con el estilo de vida y un mayor consumo de tabaco y alcohol en hombres que en mujeres, además de otras variables fisiológicas (4,9) . En sujetos centenarios (≥100 años) se encuentran anormalidades del ECG en más del 95% de los casos.…”

“…Muchas de estas alteraciones en el ECG son asintomáticas y requerirán estudios y tratamientos especializados cuando son detectados (6) . La presencia de fibrilación auricular sin cardiopatía valvular demostrable es más frecuente a medida que se incrementa la edad, por lo que se requerirá tratamiento antiarrítmico y preventivo de embolismos sistémicos que pueden ser graves (4,8,9,15) .…”

Fecal immunochemical testing for colorectal cancer and medication restrictions

“…Recent data have underlined that a better screening for atrial fibrillation discloses unknown arrhythmias not only in patients over 80 years but also in younger patients, aged 66 to 80 years. 4 Hence, the prescription of NOACs is expected to increase significantly in patients who are still concerned with FIT.…”

“…2 The FNA procedure is not the preferred modality for tissue diagnosis because of the inability to obtain tissue architecture, 3 but historically EUS-guided core biopsy specimens have been technically difficult to obtain. In the accompanying editorial, 4 it is suggested that newer, more flexible EUS core biopsy needles may become the preferred tissue sampling device. We describe 2 recent cases of AIP in which tissue was obtained with a new EUS-guided core biopsy needle, to demonstrate the ability to obtain samples with preserved architecture.…”