PROGNOSTIC VALUE OF HOLTER MONITORING IN ASYMPTOMATIC ELDERLY SUBJECTS WITH SINUS RHYTHM

Elderly people, even if asymptomatic and in apparently good cardiovasc ular condition, have a high incidence of cardiovascular events. Progno stic markers by noninvasive procedures would therefore be desirable. T he aim of this study was to evaluate the prognostic usefulness of Holt er monitoring in this setting. Holler findings in 50 asymptomatic elde rly subjects with sinus rhythm were correlated with major clinical car diovascular events occurring during a 5-year follow-up period (16% inc idence). No significant association was found with any baseline arrhyt hmia category, even complex arrhythmias such as unsustained ventricula r tachycardia, which had a 10% baseline prevalence. On the other hand, cardiovascular events were correlated (P < .01) with the presence of silent ST-segment depression (8% baseline prevalence), which seems to have an unfavorable clinical significance, in elderly, as well as youn ger, people. Holter monitoring, because of the benignity of high-preva lence findings and the very low incidence of unfavorable events, has a n overall limited prognostic usefulness in asymptomatic elderly subjec ts with sinus rhythm. In a cost-conscious medical environment, its use seems to be justified only in selected cases. I(ey words: aged, arrhy thmias, Holter monitoring.