Frequency and distribution of long-term ECG-recorded cardiac arrhythmias in an elderly population. With special reference to neurological symptoms.

The prevalence of serious episodic cardiac arrhythmias known to correlate with cerebral symptoms was investigated in 103 elderly, randomly selected persons with the aid of 22 hours of long-term ECG recording (LTER). Twelve of 26 subjects with dizziness/syncope had serious episodic arrhythmias compared with 5 of 77 subjects without these symptoms. This difference is significant (p less than 0.001). Five patients fulfilled strict criteria for pacemaker treatment of symptomatic bradycardias. Three had the sick sinus syndrome and two had third degree atrioventricular block. In 4 subjects, drugs were withdrawn due to bradycardia; and 4 were treated for tachyarrhythmias. Despite the finding of minor arrhythmnias in almost all asymptomatic subjects, it is concluded that serious episodic arrhythmias in the elderly are related to cerebral symptoms. It is also concluded that these arrhythmias are more common than previously believed and that LTER should be widely used.