Bradycardia and Tachycardia Occurring in Older People
Arrhythmias are more common in the elderly and in many situations are of prognostic importance. The incidence of arrhythmias in the elderly is increasing, most likely due to enhanced longevity. Alterations in heart rate and rhythm may occur because of age-related change within the heart. Elderly people are more likely to experience co-morbid health problems, intercurrent illness and adverse drug reactions, all of which may result in arrhythmias. Falls are a common problem in elderly people; an arrhythmic cause should always be considered.

Elderly people are more likely to experience altered cardiac conduction and symptomatic arrhythmia. This is due to age-related changes within the heart, an increased likelihood of co-morbid health problems, and a reduced tolerance of anti-arrhythmic drug therapy.

In an earlier article, we discussed atrial fibrillation in the elderly. In this article we discuss the background to bradycardias and tachycardias, including epidemiology and presentation. The investigations needed for bradycardias and tachycardias, and its management, with particular emphasis on device therapy, will be reviewed in the next issue.