Abstract 100: Electrocardiographic Changes in Patients ≥ 100 Years Of Age

Abstract

Background: Centenarian population in the United States is increasing, and cardiovascular disease is the most common cause of death in this group of patients. We report electrocardiographic changes in a group of 124 centenarians. METHODS: We included ECGs of 124 patients aged 100 to 112 years (mean age 102 years), who were seen either on office visits or on recent admission to the hospital. ECGs were analyzed by 2 different investigators. Results: Women were at least 2 times men in number (31% vs 69%, 39 vs 85 of 124); thus women outlived men in the centenarian group. 58% (72 of 124) patients had normal sinus rhythm and only 7 of 124 patients (6%, all women) had normal ECGs. The most common electrocardiographic abnormalities were: left-axis deviation (29%, 36 of 124), atrial fibrillation (AF) (27%, 34 of 124), right bundle branch block (15%, 18 of 124), left anterior fascicular block (14%, 17 of 124), left ventricular hypertrophy (14%, 17 of 124), first-degree atrioventricular (AV) block (13%, 16 of 124), nonspecific ST-T changes (13%, 16 of 124), premature atrial complexes (13%, 16 of 124), premature ventricular complexes (10%, 13 of 124) and pacemaker rhythm (10%, 13 of 124). Almost all Q waves were suggestive of old inferior wall infarcts and were present in 8% (10 of 124) of patients. Only 3 centenarians had QTc prolongation. Conclusion: Fewer men live long enough to reach 100 years of age, consistent with higher incidence of ischemic heart disease in men. Centenarians had higher incidence of AF indicative of increased incidence of AF with age. Increased incidence of left-axis deviation, left anterior fascicular block and left ventricular hypertrophy in centenarians can be attributed to age related cardiac hypertrophy and prevalence of hypertension. Also higher prevalence of conduction disturbances including AV block and bundle branch block indicates that a degenerative conduction system disorder may progress with advancing age. The finding of pacemaker rhythm in a few subjects confirms that pacemaker implantation may allow some patients to reach extreme longevity. Overall centenarians represent a model of successful aging and have satisfactory electrocardiographic framework that reflects a good cardiac function, contributing to attainment of extreme longevity.