Age-related reference intervals for ambulatory electrocardiographic parameters in healthy individuals

Kenichi Hashimoto; Naomi Harada; Motohiro Kimata; Yusuke Kawamura; Naoya Fujita; Akinori Sekizawa; Yosuke Ono; Yasuhiro Obuchi; Tadateru Takayama; Yuji Kasamaki; Yuji Tanaka

doi:10.3389/fcvm.2023.1099157

Age-related reference intervals for ambulatory electrocardiographic parameters in healthy individuals

Front Cardiovasc Med. 2023 Mar 6:10:1099157. doi: 10.3389/fcvm.2023.1099157. eCollection 2023.

Authors

Affiliations

¹ Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
² Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
³ Department of General Medicine, Nihon University School of Medicine, Tokyo, Japan.
⁴ Department of General Medicine, Kanazawa Medical College Himi Municipal Hospital, Himi, Toyama, Japan.

Abstract

Background: The advent of novel monitoring technologies has dramatically increased the use of ambulatory electrocardiography (AECG) devices. However, few studies have conducted detailed large-scale investigations on the incidence of arrhythmias over 24 h, especially ectopy, in healthy individuals over a wide age range.

Objectives: This study aimed to investigate the incidence of arrhythmias detected using AECG and associated factors, in healthy individuals, over a wide age range.

Methods: In this cross-sectional study, we performed AECG on 365 healthy volunteers (median [interquartile range]: 48 [36, 67], 20-89 years, 165 men) under free-running conditions for 24 h. Ultrasonic echocardiography and heart rate variability analysis were performed to explore the factors associated with the incidence of arrhythmias.

Results: The 97.5th percentile of single ventricular ectopy (VE) was 149/day, 254/day, and 1,682/day in the 20-39-, 40-59- and 60-89-year age groups, respectively; that of single supraventricular ectopy (SVE) was 131/day, 232/day, and 1,063/day, respectively. Multivariate analysis revealed that aging was the only independent significant factor influencing the frequency of VE (β = 0.207, P = 0.001). Age (β = 0.642, P < 0.001), body mass index (BMI) (β = -0.112, P = 0.009), and the root mean square of successive differences in RR intervals (β = 0.097, P = 0.035) were factors significantly associated with SVE frequency.

Conclusions: Age-specific reference intervals of VE and SVE in a large population of healthy participants over a wide age range were generated. VE and SVE increased with age; SVE was influenced by BMI and the aging-induced decrease in parasympathetic tone activity.

Keywords: Holter ECG monitoring; amburatory ECG monitoring; atrial fibrillation; heart rate variability; premature atrial complex (PAC); premature ventricular complex (PVC).

Grants and funding

This work was supported by Grants-in-Aid for Scientific Research in Japan (JSPS KAKENHI) [Grant Number 20K07816] provided by the Japanese Society of Promotion of Science.