Tàmmaro A E, Ronzoni D, Bonaccorso O, Buttè M, Carella G R, Colombo A M, Cottino M, Frustaglia A, Gemmellaro P, Picceo M T, Trezza L, Tricella G
Minerva Med. 1983 May 19;74(21):1313-8.
A survey was made on a population of 6059 subjects aged more than 60 years with the aim to assess 1. the prevalence of heart arrhythmias and 2. the relationships between arrhythmias and some other ecg alterations. Arrhythmias resulted present in 29.0% of the whole population with a significantly higher prevalence among males (30.7% vs 28.1%, P less than 0.05) and among subjects over 75 years of age (33.2% vs 23.9%, P less than 0.001). Supraventricular extrasystoles (SE, 11.55%), atrial fibrillation (AF, 10.44%) and ventricular extrasystoles (VE, 8.91%) were the most frequent arrhythmias, followed by sinus bradycardia (SB, 2.04%), sinus arrhythmia (SA, 1.35%), atrial flutter (AFL, 1.09%) and junctional rhythms (JR, 0.20%). AF and AFL resulted significantly more frequent among females, whilst SE, VE and SB were more frequent among males. All the above arrhythmias, with the exception of AFL and JR resulted significantly more frequent among subjects over 75. A significantly higher prevalence of ecg signs of left ventricular hypertrophy, ischemia, previous myocardial infarction (MI) and of the so-called "minor" T-wave changes (MTC) was found among the subjects with arrhythmia as compared with those free from rhythm disturbances. Ecg signs of MI and MTC were significantly more frequent among males and MTC were more frequent among females and among subjects over 75. It is concluded that in an old person the presence of an arrhythmia should lead to a careful evaluation of the general and cardiological clinical situation in order to avoid 1. to prescribe an unnecessary and potentially dangerous antiarrhythmic treatment, and 2. to misdiagnose an underlying clinical condition liable to a decisive improvement under adequate treatment.
对6059名60岁以上的受试者进行了一项调查，目的是评估：1. 心律失常的患病率；2. 心律失常与其他一些心电图改变之间的关系。结果显示，心律失常在整个人口中的患病率为29.0%，男性患病率显著更高（30.7%对28.1%，P<0.05），75岁以上受试者中的患病率也显著更高（33.2%对23.9%，P<0.001）。室上性早搏（SE，11.55%）、心房颤动（AF，10.44%）和室性早搏（VE，8.91%）是最常见的心律失常，其次是窦性心动过缓（SB，2.04%）、窦性心律失常（SA，1.35%）、心房扑动（AFL，1.09%）和交界性心律（JR，0.20%）。AF和AFL在女性中更为常见，而SE、VE和SB在男性中更为常见。除AFL和JR外，上述所有心律失常在75岁以上的受试者中更为常见。与无节律紊乱的受试者相比，心律失常受试者中左心室肥厚、缺血、既往心肌梗死（MI）和所谓“轻微”T波改变（MTC）的心电图征象患病率显著更高。MI和MTC的心电图征象在男性中更为常见，MTC在女性和75岁以上的受试者中更为常见。结论是，对于老年人，心律失常的存在应促使对其整体和心脏临床状况进行仔细评估，以避免：1. 开具不必要且可能危险的抗心律失常治疗；2. 误诊可能在适当治疗下得到决定性改善的潜在临床状况。
