Koya Mizutani

Arrhythmias in Centenarians

Background: Many studies have shown an increase in the prevalence of arrhythmias with advancing age. However, little is known about arrhythmias in centenarians. Method and Results: Thirty‐two Japanese centenarians aged 100–106 years (14 males, 18 females) were studied. All of them had 12‐lead EGGs, and 22 also had 24‐hour ambulatory monitoring. As controls, 89 healthy Japanese elderly from the same geographic area underwent 12‐lead ECG. Their mean age was 75 ± 6 years with a range of 63–93 years, and there were 28 males and 61 females. Twenty‐three of them also had Holter ECGs. On the 12‐lead ECG, the heart rate was slightly, but significantly, higher in the centenarians (76.8 ± 12.7 beats/min) than that in the elderly subjects (74.9 ± 5.9 beats/min, P < 0.005). PQ and QTC were significantly longer in the centenarians (174 ± 29 and 439 ± 33 msec, respectively) compared with the elderly subjects (158 ± 23 and 417 ± 31 msec, P < 0.005 and P < 0.001, respectively). Supraventricular premature beats (SVPBs) were observed in 31% of the centenarians and in 4% of the elderly subjects (P < 0.001). First‐ and second‐degree AV block was recorded in 25% of the centenarians and 1% of the elderly subjects (P < 0.001). Right bundle branch block was found in 19% of the centenarians and 7% of the elderly subjects (P < 0.05). There were no differences in the frequency of ventricular premature beats (VPBs) or QRS voltage. On the Holter ECG, there were no significant differences in average heart rate, maximum heart rate, minimum heart rate, or the longest RR interval. A subgroup of centenarians had frequent SVPBs. However, none of them had > 1,000 VPBs/day as opposed to four elderly subjects (P < 0.01). Atrial fibrillation was not observed in any records of the centenarians despite the presence of frequent SVPBs. Conclusion: These data suggest that conduction disturbances of the AV nodal—His‐Purkinje system and frequent SVPBs are common in centenarians, whereas very frequent VPBs and atrial fibrillation seem less common.