Arrhythmias in people over 65

• As people get older they are more likely to have a cardiac arrhythmia which may be associated with a substantial risk to health.
• This is often as a result of the process of ageing and changes related to disease, such as ischaemic heart disease, and changes to the heart’s structure.
• The symptoms may be vague – falls, dizziness, fatigue, blackouts, confusion etc.
• Atrial fibrillation or flutter is the most common arrhythmia in the elderly. With atrial fibrillation, (as in all ages), stroke prevention (by the use of anticoagulant medication) is very important.
• Bundle branch block is common in the elderly.
• It is not normal for an older person to have bradycardia (slow heartbeat) and it is normally indicative of an underlying conduction disturbance, which may need pacemaker treatment.
• Tachycardia (fast heartbeat) is less well tolerated in the older person and can precipitate low blood pressure (hypotension), angina and heart failure.
• The management of arrhythmia in an older person is basically the same as for people of other age groups but an underlying cause should always be borne in mind.
• An older person may already be on anti-arrhythmic drugs, (which in themselves may cause an arrhythmia) and is likely to be on other medication; potential drug interactions have to be considered.