ARRHYTHMIAS IN CENTENARIANS

Background: Many studies have shown an increase in the prevalence of a rrhythmias with advancing age. However, little is known about arrhythm ias in centenarians. Method and Results: Thirty-two Japanese centenari ans aged 100-106 years (14 males, 18 females) were studied. All of the m had 12-lead ECGs, and 22 also had 24-hour ambulatory monitoring. As controls, 89 healthy Japanese elderly from the same geographic area un derwent 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 slig htly, but significantly, higher in the centenarians (76.8 +/- 12.7 bea ts/min) than that in the elderly subjects (74.9 +/- 5.9 beats/ min, P < 0.005). PQ and QT(c) were significantly longer in the centenarians ( 174 +/- 29 and 439 +/- 33 msec, respectively) compared with the elderl y subjects (158 +/- 23 and 417 +/- 31 msec, P < 0.005 and P < 0.001, r espectively). Supraventricular premature beats (SVPBs) were observed i n 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 centen arians 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 subj ects (P < 0.05). There were no differences in the frequency of ventric ular premature beats (VPBs) or QRS voltage. On the Holter ECG, there w ere no significant differences in average heart rate, maximum heart ra te, minimum heart rate, or the longest RR interval. A subgroup of cent enarians had frequent SVPBs. However, none of them had > 1,000 VPBs/da y as opposed to four elderly subjects (P < 0.01). Atrial fibrillation was not observed in any records of the centenarians despite the presen ce of frequent SVPBs. Conclusion: These data suggest that conduction d isturbances of the AV nodal-His-Purkinje system and frequent SVPBs are common in centenarians, whereas very frequent VPBs and atrial fibrill ation seem less common.