Cardiac Arrhythmias and Conduction Disorders in Geriatric Patients with Cardiovascular Comorbidity
Cardiac Arrhythmias and Conduction Disorders in Geriatric Patients with Cardiovascular Comorbidity
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Original abstract
Introduction. The polymorbidity characteristic of geriatric patients exerts a complex impact on the regulatory mechanisms of cardiac function, significantly increasing the likelihood of arrhythmias and conduction disturbances when compared to younger age groups. The aim of this study is to examine the frequency of arrhythmias and conduction disorders in geriatric patients with comorbid cardiovascular pathology in order to identify gender-specific features. Materials and methods. A retrospective analysis was conducted on 50 medical histories of patients from the cardiology department of the Republican Clinical Hospital No. 4 in Saransk in 2024. The inclusion criteria for the study were elderly patients aged 75 to 89 years, diagnosed arrhythmias and conduction disorders of the heart, and the presence of comorbid cardiovascular pathology. A comparative analysis within the group was performed considering gender as a variable.Results. The predominant type of arrhythmia in 80% of geriatric patients was atrial fibrillation (with a male predominance of 1.5 times), characterized by a predominance of persistent form (in 62.5% of cases). The frequency of supraventricular and ventricular extrasystoles was 28% (without significant gender differences), while Wolff – Parkinson – White syndrome was observed in 8% of cases (equally distributedbetween men and women), and atrial flutter in 8% (with a threefold male predominance). Supraventricular paroxysmal tachycardia was found in 2% of cases (in men). Conduction disturbances were identified in 34% of patients, with a male predominance of 1.8 times. The most common finding was first-degree atrioventricular block (AV block), present in 47.1% of all cases. More severe forms of AV block (second- and third-degree) were diagnosed in 17.6% of patients, left bundle branch block in 35.3%, with a twofold male predominance. Post-infarction cardiomyosclerosis was observed 1.5 times more frequently in men. Chronic heart failure with reduced ejection fraction was diagnosed twice as often in men, with a predominance of functional classes 2–4. Arterial hypertension and acute cerebrovascular accidents in the history were more frequently observed in men, whereas type 2 diabetes and obesity were observed twice as often in women. Strong positive correlations were established between rhythm and conduction disturbances in both sexes and the presence of arterial hypertension, chronic heart failure, and ischemic heart disease.Discussion and conclusion. The development of arrhythmias and their complications is often driven by concomitant cardiovascular diseases. Comorbidity in geriatric patients with rhythm and conduction disorders significantly increases cardiovascular risk. Identified gender differences in the morbidity rates among geriatric patients highlight the necessity of addressing modifiable risk factors and conducting thorough monitoring of rhythm and conduction disturbances in the presence of concomitant cardiovascular pathology when planning treatment strategies. This approach is crucial for achieving target blood pressure levels, modulating cardiac activity, and managing associated cardiovascular conditions.