P4471Age-related dynamics of atrial fibrillation during 12-year follow-up in elderly population sample

Aim: To study the prevalence and cumulative incidence of arrhythmias in the general population of adults aged 60 and older over a 6-year period. Study Design and Setting: Data were taken from the Swedish National Study on Aging and Care (SNAC), a national, longitudinal, multidisciplinary study of the general elderly population (defined as 60 years of age or older). A 12-lead resting electrocardiography (ECG) was performed at baseline and 6-year follow-up. Results: The baseline prevalence of atrial fibrillation (AF) was 4.9% (95% confidence interval [CI] = [4.5%, 5.5%]), and other arrhythmias including ventricular premature complexes (VPCs), supraventricular tachycardia (SVT), and supraventricular extrasystole (SVES) were seen in 8.4% (7.7%, 9.0%) of the population. A first- or second-degree atrioventricular (AV) block was found in 7.1% of the population (95% CI = [6.5%, 7.7%]), and there were no significant differences between men and women in baseline arrhythmia prevalence. The 6-year cumulative incidence of AF was 4.1% (95% CI = [3.5%, 4.9%]), or 6.9/1,000 person-years (py; 95% CI = [5.7, 8.0]). The incidence of AF, other arrhythmias, AV block, and pacemaker-induced rhythm was significantly higher in men in all cohorts except for the oldest. Conclusion: Our data highlight the prevalence and incidence of arrhythmias, which rapidly increase with advancing age in the general population.

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P3511Gender differences in electrocardiographic risk markers of heart failure

European Heart Journal ◽

10.1093/eurheartj/ehz745.0375 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M A E Haukilahti ◽

T V Kentta ◽

J Tikkanen ◽

O Anttonen ◽

A Aro ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Heart Rate ◽

Population Sample ◽

Left Ventricular ◽

Western World ◽

Mobile Clinic ◽

Middle Aged ◽

T Wave

Abstract Background Heart failure (HF) is one the leading causes of hospitalization in the Western world. Women have a lower rate of HF hospitalization and mortality compared to men. Role of 12-lead electrocardiography (ECG) as a risk marker of future HF in women is not well known. Purpose We studied the association of standard 12-lead ECG and clinical risk factors to HF hospitalization in women and in men separately from a large middle aged general population sample with a long-term follow-up. Methods Standard 12-lead ECG markers were analyzed from 10,864 subjects (48.8% women, N=5,215) of the prospective Mobile Clinic Study, and their predictive value for HF hospitalization was analyzed. Results During the follow-up (29.6±11.2 yrs.), a total of 1,743 subjects had HF hospitalization; out of these, 861 were women (49.4%). Several baseline characteristics, such as age, body mass index, blood pressure, and history of prior cardiac disease predicted the occurrence of HF both in women and men (P<0.001 for all). After adjusting for baseline variables, ECG sign of left ventricular hypertrophy (LVH) (P<0.001), and atrial fibrillation (P<0.001) were the only baseline ECG variables that predicted the future HF in women. In men, HF was predicted by fast heart rate (P=0.008), T wave inversions (P<0.001), abnormal Q waves (P=0.002), and atrial fibrillation (P<0.001). Statistically significant gender interactions in prediction of HF were observed in ECG sign of LVH (P<0.001), inferolateral T wave inversions (P=0.005), and heart rate (P=0.012). Conclusions ECG sign of LVH predicts future HF in middle-aged women independently, and T wave inversions and elevated heart rate are associated with HF hospitalization in men in. Acknowledgement/Funding Finnish Cultural Foundation, The University of Oulu Scholarship Foundation, Juho Vainio Foundation

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Relationship between 24- hour Holter variables, chest discomfort and syncope: Does age matter?

International Cardiovascular Forum Journal ◽

10.17987/icfj.v1i2.28 ◽

2015 ◽

Vol 1 (2) ◽

pp. 90

Author(s):

Samir Saha

Keyword(s):

Atrial Fibrillation ◽

Elderly Population ◽

Human Subjects ◽

Tertiary Care ◽

Holter Monitoring ◽

The Elderly ◽

Cardiac Events ◽

Tertiary Care Centers ◽

Rate Profile

One hundred and forty four ambulatory, non-emergent human subjects from 20-88 years of age were investigated following routine 24 hour Holter monitoring referred by primary and tertiary care centers primarily for evaluation of palpitations and syncope. The patients were grouped into 3 different age categories: A) 20-59 years of age (16%), B) 60-69 years of age (26.4%) and C) > 70 years of age (57.6%). Heart rate profile, RR intervals, symptoms, frequency of premature supra ventricular and ventricular complexes were registered. The data show that though the occurrence and frequency of premature atrial and ventricular contractions over a period of 24 hours did not differ between the groups, the younger subjects documented more subjective discomforts during the Holter monitoring. Extra-systoles in excess of 1000 beats / 24 hour occured incessantly throughout the registration. Patients with syncope and those without did not differ as regards the Holter variables. However, subjects with atrial fibrillation had acceptable rate control and had significantly lower incidence of syncope than those with sinus rhythm. The findings suggest that in a county setting, Holter monitoring for evaluation of syncope may not be the first hand mode of investigation in a non emergent setting. On the contrary, the modality appears to be valuable for monitoring patients with atrial fibrillation. Even mild symptoms in the elderly population may warrant closer clinical follow up to prevent cardiac events and/or syncope leading to serious physical injury.

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DREAM LIFE AND INTRAPSYCHIC BOUNDARIES IN THE ELDERLY

Social Behavior and Personality An International Journal ◽

10.2224/sbp.2001.29.6.557 ◽

2001 ◽

Vol 29 (6) ◽

pp. 557-568 ◽

Cited By ~ 1

Author(s):

Arthur T. Funkhouser ◽

Othmar Würmle ◽

Claude M. Cornu ◽

Marcel Bahro

Keyword(s):

Elderly Population ◽

Population Sample ◽

The Elderly ◽

Living Situation ◽

Retest Reliability ◽

Healthy Elderly ◽

Screening Questions

Sixty-one mentally healthy elderly Swiss subjects (mean age: 71.8 5.5 years) participated in a 1998 investigation into the effects of “dream-telling”. Along with a number of questions about their living situation and other tests, the Hartmann Boundary Questionnaire (BQ) was administered twice, at the beginning and again at the end of the twenty-six week study period. Retest reliability of the questionnaire was acceptably high (r = 0.872). The study presented here examines some relationships between factors as measured by two screening questions and by follow-up questions and the BQ scores. In the screening questions, for example, it was found that those who had had psychotherapy or had taken dream courses had significantly thinner boundaries than those who had not. This relationship did not hold, though, for those who said they paid attention to their dreams. Further questions in the follow-up phase showed also that those with thinner boundaries were more concerned with dreams. It was not clear, however, why indecisive persons in this elderly population sample should have thinner boundaries nor why those with thinner boundaries are more discontented with their bodily situations and/or with their family situations.

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Association of cardiovascular health and incident atrial fibrillation in elderly population

Heart ◽

10.1136/heartjnl-2020-318858 ◽

2021 ◽

pp. heartjnl-2020-318858

Author(s):

Jae-Hyuk Lee ◽

Pil-Sung Yang ◽

Hee Tae Yu ◽

Tae-Hoon Kim ◽

Eunsun Jang ◽

...

Keyword(s):

Atrial Fibrillation ◽

National Health ◽

Elderly Population ◽

Cardiovascular Health ◽

Multivariable Analysis ◽

Heart Association ◽

The Elderly ◽

Newly Diagnosed ◽

Point Increase

ObjectiveTo evaluate whether baseline and changes in cardiovascular health (CVH) were related to incident atrial fibrillation (AF) risk in the elderly population.MethodsFrom the Korea National Health Insurance Service-Senior cohort, we included 208 598 participants without prior AF (median age: 70 (IQR 66–74) years; 90 916 (43.6%) men) who underwent national health check-ups between 1 January 2005 and 31 December 2012. Using the six metrics of the American Heart Association, participants were categorised as having low, moderate and high CVH.ResultsOver a median follow-up of 7.2 years, 7818 cases of incident AF occurred. In multivariable analysis, moderate (HR: 0.90; 95% CI: 0.86 to 0.94) and high (HR: 0.81; 95% CI: 0.73 to 0.91) CVH status at baseline were associated with a lower risk of incident AF. However, in 109 695 participants with changes in CVH between the first and second check-ups, the direction of change in CVH scores showed no consistent association with future AF incidence. In newly diagnosed participants with AF, the incidence of the composite outcome (stroke, major bleeding and all-cause death) decreased with every 1-point increase in the baseline CVH score (HR: 0.94; 95% CI: 0.89 to 0.99).ConclusionsIn the general elderly population, better baseline CVH metrics were associated with lower incident AF risk. In participants with newly diagnosed AF, better CVH was also associated with lower incidence of future composite outcomes. However, the direction of change in CVH status within 2 years showed an inconsistent influence on incident AF risk.

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Determinants of Stroke in a General Male Population

Stroke ◽

10.1161/strokeaha.118.022740 ◽

2018 ◽

Vol 49 (12) ◽

pp. 2830-2836 ◽

Cited By ~ 3

Author(s):

Carina U. Persson ◽

Kurt Svärdsudd ◽

Linnéa Rusek ◽

Christian Blomstrand ◽

Ann Blomstrand ◽

...

Keyword(s):

Atrial Fibrillation ◽

Population Sample ◽

Population Based ◽

Activity Level ◽

High Educational Level ◽

Male Population ◽

Increased Risk ◽

General Male Population ◽

Medical Examinations

Background and Purpose— To further improve preventive strategies against stroke, there is a need for epidemiological long-term studies. The study aimed at a prospective investigation of stroke determinants in the general male population. Methods— During a period of 48 years, from 50 to 98 years of age, a population-based sample of 854 men was followed using repeated medical examinations, lifestyle questionnaires, data from hospital records and the National Cause of Death Register. Results— Determinants of ischemic stroke were atrial fibrillation (hazard ratio [HR], 6.61; 95% CI, 4.47–9.77); mother dead from cardiovascular disease (HR, 1.53; 1.09–2.17); high education (HR, 0.81; 0.69–0.96); and high physical activity level during leisure time (HR, 0.68; 0.50–0.93). For hemorrhagic stroke heart rate (HR, 1.04; 1.01–1.06) and mother dead from stroke (HR, 3.56; 1.43–8.87) constituted an increased risk. Statistically significant determinants for all stroke were atrial fibrillation (HR, 5.34; 3.68–7.75); high diastolic blood pressure (HR, 1.02; 1.01–1.03); high body weight (HR, 0.96; 0.94–0.99); high educational level (HR, 0.79; 0.68–0.92); wide waist circumference (HR, 1.04; 1.01–1.07); smoking (HR, 1.25; 1.06–1.48); mother dead from cerebrovascular disease (HR, 1.43; 1.05–1.94); and diabetes mellitus (HR, 1.65; 1.02–2.68). Of all men diagnosed with atrial fibrillation, 88% had a stroke during follow-up. Conclusions— Atrial fibrillation was by far the strongest determinant of stroke during 48 years of follow-up in a male population sample followed until the age of 98 years. The results warrant improved prophylaxis through intense treatment of modifiable determinants.

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