The prevalence of cardiac ectopy in elderly patients with echocardiographically normal hearts is not increased by significant coronary artery disease.

ISSUE: A higher frequency of abnormal heart rhythms has previously been shown in elderly subjects with overtly normal hearts as demonstrated by noninvasive testing. However, no prior study on elderly patients with echocardiographically structurally normal hearts has distinguished cardiac dysrhythmia incidence based on the presence or absence of angiographically documented coronary artery disease (CAD).

METHODS

We performed 24-hour ambulatory monitoring on patients with no coronary stenosis of greater than 30% and normal left ventricular (LV) systolic function by angiography. This group was then compared with a group of elderly patients with normal LV systolic function and at least one major coronary artery stenosis of 70% or greater. All patients had echocardiographically normal LV wall thickness and systolic function and no significant valvular disease.

RESULTS

The experimental group was composed of 15 patients with CAD aged 71 +/- 6 years. The control group without significant CAD was composed of 20 patients aged 73 +/- 4 years (P = not significant [NS]). There was no difference with respect to prevalence of hypertension, use of calcium-channel blockers, and history of smoking. There was no difference between the groups with regard to the number of premature atrial contractions (467 +/- 759 [experimental] vs 672 +/- 1789 [control]; P = NS); premature ventricular contractions (359 +/- 599 [experimental] vs 290 +/- 858 [control]; P = NS); and prevalence of ventricular couplets, ventricular tachycardia, paroxysmal atrial fibrillation, and supraventricular tachycardia (all P = NS).

CONCLUSIONS

These findings indicate that the prevalence of cardiac dysrhythmias in elderly patients with echocardiographically normal hearts is not influenced by the presence of angiographically significant CAD.