Baratta L, Maffeo N, Tubani L, Paradiso M, Molaioni C, Coppotelli L, Laganà B, Mastrocola C, Cordova C
Dipartimento di Medicina Clinica, Università La Sapienza, Roma.
Recenti Prog Med. 1996 Mar;87(3):96-101.
Objective of our study was to evaluate the prevalence of arrhythmias as well as their correlation with the reported anamnestic symptomatology in the elderly population. With 24 hour ambulatory electrocardiography (Holter ECG) 913 patients, (440 males and 473 females, range 60-89 years, mean age 71) were consecutively studied and subdivided according to the following criteria: (1) age (3 classes: 60-69 [I], 70-79 [II], > or = 80 [III]; (2) presence/absence of "guide" symptoms (syncope/faintness, chest pain, palpitation), and (3) Holter electrocardiography results. We have demonstrated a high prevalence of arrhythmias: 72% (657), which was significantly higher in age classes II (80.5%) and III (79.1%) in comparison to class I (60.6%). A notably higher prevalence of tachyarrhythmias is documented compared to bradyarrhythmias (5:1). With a higher age the prevalence of supraventricular tachyarrhythmias increases significantly, while bradyarrhythmias do not have the same trend. We have a similar prevalence of arrhythmias between symptomatic (77.4%) and asymptomatic patients (63.6%) and no significant correlation between anamnestic symptoms and presence of arrhythmias are observed. Considering the high prevalence of arrhythmias during Holter ECG we think that the clinical importance and prognosis should be evaluated with caution.
我们研究的目的是评估老年人群中心律失常的患病率及其与所报告的既往症状学的相关性。通过24小时动态心电图(Holter心电图),对913例患者(440例男性和473例女性,年龄范围60 - 89岁,平均年龄71岁)进行了连续研究,并根据以下标准进行细分:(1)年龄(3个类别:60 - 69岁[I],70 - 79岁[II],≥80岁[III]);(2)是否存在“引导”症状(晕厥/头晕、胸痛、心悸);(3)Holter心电图结果。我们证实心律失常的患病率很高:72%(657例),与I类(60.6%)相比,II类(80.5%)和III类(79.1%)的心律失常患病率显著更高。与缓慢性心律失常相比,记录到的快速性心律失常患病率明显更高(5:1)。随着年龄的增加,室上性快速性心律失常的患病率显著增加,而缓慢性心律失常则没有相同的趋势。有症状患者(77.4%)和无症状患者(63.6%)的心律失常患病率相似,且未观察到既往症状与心律失常存在之间的显著相关性。考虑到Holter心电图期间心律失常的高患病率,我们认为应谨慎评估其临床重要性和预后。