Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 15:337:64-70.
doi: 10.1016/j.ijcard.2021.05.006. Epub 2021 May 6.

Frequency of cardiac arrhythmias in older adults: Findings from the Subclinical Atrial Fibrillation and Risk of Ischemic Stroke (SAFARIS) study

Carlo Mannina  1 , Zhezhen Jin  2 , Kenji Matsumoto  3 , Kazato Ito  3 , Angelo Biviano  3 , Mitchell S V Elkind  4 , Tatjana Rundek  5 , Shunichi Homma  3 , Ralph L Sacco  6 , Marco R Di Tullio  7
Affiliations

Frequency of cardiac arrhythmias in older adults: Findings from the Subclinical Atrial Fibrillation and Risk of Ischemic Stroke (SAFARIS) study

Carlo Mannina et al. Int J Cardiol. .

Abstract

Background: Prolonged monitoring of cardiac rhythm has been used to screen for subclinical atrial fibrillation (AF); little is known about other arrhythmias in the general population, especially in the elderly, who are at higher risk of arrhythmias.

Methods: We evaluated the frequency of arrhythmias in the tri-ethnic (white, Black, Hispanic), community-based Subclinical Atrial Fibrillation and Risk of Ischemic Stroke (SAFARIS) study using a patch-based recorder for up to 14 days in 527 participants free of AF, congestive heart failure (CHF) or history of stroke. Differences according to gender, age, ethnicity and presence of hypertension, diabetes and pertinent ECG and echocardiographic variables were examined.

Results: Mean age was 77.2 ± 6.8 years (37.2% men, 62.8% women). AF was present in 10 participants (1.9%), only 2 of them symptomatic. Supraventricular tachycardia (SVT) and ventricular tachycardia (VT) episodes were observed in 84.4% and 25.0% but only 13.5% and 10.6% of participants reported symptoms, respectively. Severe bradycardia (<40 bpm) was present in 12.5%. Sinus pauses and high-degree atrioventricular blocks were infrequent (2.1% and 1.5%, respectively). Most arrhythmias were more frequent in participants > 75 years; ventricular arrhythmias and severe bradycardia were more common in men. Whites had significantly more episodes of AF than Hispanics, SVT than Blacks and VT ≥ 10 beats than Hispanics and Blacks. Hypertensives had more episodes of severe bradycardia. LV hypertrophy or LVEF <55% were associated with more frequent ventricular and supraventricular arrhythmias.

Conclusions: Prolonged cardiac rhythm monitoring revealed moderate frequency of AF, but higher than expected frequencies of AF-predisposing arrhythmias. Ventricular arrhythmias were relatively frequent, whereas severe bradyarrhythmias were infrequent.

Keywords: Atrial fibrillation; Bradycardia; Cardiac arrhythmias; Cardiac complexes; Electrocardiography; Premature; Tachycardia.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest Dr. Biviano has served an advisory Boards for Boston Scientific and Biosense Webster. Dr. Elkind reports receiving study drug in kind from the BMS-Pfizer Alliance for Eliquis and ancillary funding from Roche for the NIH-funded ARCADIA trial of apixaban vs aspirin for stroke prevention; and Dr. Elkind's institution, Columbia University, received payments through a service agreement for his participation in analyses of study data. Dr. Elkind received no personal compensation for any of these activities. Dr. Homma reports being a consultant for St. Jude Medical, Daiichi-Sankyo, Bristol Meyers Squibb, Pfizer. Dr. Sacco has received research grants from NINDS, NCATS, AHA, Evelyn McKnight Brain Foundation and Boehringer Ingelheim. The other authors have no disclosures.

Figures

Figure 1
Figure 1
Frequency of arrhythmias in the study cohort. Values in figure are expressed as percentages. AF: Atrial fibrillation. A/Flutter: Atrial flutter. SVT: Supraventricular tachycardia. PAC: Premature atrial contraction. VT: Ventricular tachycardia. PVC: Premature ventricular contraction. AVB: Atrial ventricular block
Figure 2
Figure 2
Frequency of arrhythmias by sex Values in figure are expressed as percentage *p<0.01 §p<0.001 AF: Atrial fibrillation. SVT: Supraventricular tachycardia. PAC: Premature atrial contraction. VT: Ventricular tachycardia. PVC: Premature ventricular contraction. HR: Heart rate
Figure 3
Figure 3
Frequency of arrhythmias according to age (< or ≥ 75 years). Values in figure are expressed as percentage *p <0.05 §p <0.01 † p<0.0001 AF: Atrial fibrillation. SVT: Supraventricular tachycardia. PAC: Premature atrial contraction. VT: Ventricular tachycardia. PVC: Premature ventricular contraction. HR: Heart rate
Figure 4
Figure 4
Frequency of arrhythmias by race-ethnicity Values in figure are expressed as percentage * p<0.05 AF: Atrial fibrillation. SVT: Supraventricular tachycardia. PAC: Premature atrial contraction. VT: Ventricular tachycardia. PVC: Premature ventricular contraction. HR: Heart rate
See this image and copyright information in PMC

References

    1. Stahrenberg R, Weber-Kruger M, Seegers J, Edelmann F, Lahno R, Haase B, et al. Enhanced detection of paroxysmal atrial fibrillation by early and prolonged continuous holter monitoring in patients with cerebral ischemia presenting in sinus rhythm. Stroke. 2010;41(12):2884–8. - PubMed
    1. Gladstone DJ, Spring M, Dorian P, Panzov V, Thorpe KE, Hall J, et al. Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med. 2014;370(26):2467–77. - PubMed
    1. Heckbert SR, Austin TR, Jensen PN, Floyd JS, Psaty BM, Soliman EZ, et al. Yield and consistency of arrhythmia detection with patch electrocardiographic monitoring: The Multi-Ethnic Study of Atherosclerosis. J Electrocardiol. 2018;51(6):997–1002. - PMC - PubMed
    1. Gladstone DJ, Wachter R, Schmalstieg-Bahr K, Quinn FR, Hummers E, Ivers N, et al. Screening for Atrial Fibrillation in the Older Population: A Randomized Clinical Trial. JAMA Cardiol. 2021. - PMC - PubMed
    1. Rooney MR, Soliman EZ, Lutsey PL, Norby FL, Loehr LR, Mosley TH, et al. Prevalence and Characteristics of Subclinical Atrial Fibrillation in a Community-Dwelling Elderly Population: The ARIC Study. Circ Arrhythm Electrophysiol. 2019;12(10):e007390. - PMC - PubMed