Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly.

To determine the prevalence of palpitations, cardiac arrhythmias and associated cardiovascular risk factors in an ambulatory elderly population, 1454 ambulatory elderly people (219 men and 1235 women, age range 60-94 years) were assessed in a territory-wide health survey including anthropometric measurements, biochemical blood tests, questionnaire interview and resting surface ECG examination. Prevalence of palpitations and ECG abnormalities were determined and correlated with coronary risk factors and biochemical blood tests. Palpitations were present in 121 subjects (8.3%) and cardiac arrhythmias were found in 183 subjects (12.6%). Conduction abnormalities and sinus bradycardia were the commonest findings (9.8%). Premature beats (atrial 2.3%; ventricular 1%) were the next most frequent arrhythmia. Atrial fibrillation was the commonest sustained arrhythmia that was present in 19 subjects (1.3%). Compared with those without arrhythmia on ECG, people with arrhythmias were predominantly males and were older (72 +/- 8 years vs. 70 +/- 6 years, P < 0.05), had a higher prevalence of smoking (12.9% vs. 5%, P < 0.05) and coronary heart disease (30.7% vs. 11.4%, P < 0.05). The prevalence of palpitations between subjects with documented arrhythmias (excluding conduction disturbance) and those without arrhythmias on surface ECG was similar (9% vs. 7.7%, P = N.S.). We conclude that cardiac arrhythmias are common in the elderly and are often asymptomatic. Subjects with ECG documented arrhythmias are more common in males, and are associated with smoking and ischaemic heart disease. Palpitation was a frequent complaint in the ambulatory elderly with no bearing on arrhythmias recorded on resting ECG.