Abstract
Objective—To characterise cardiac arrhythmias and cardiac autonomic function in 11 elderly men (mean (SD) age 73.2 (2.8) years) with a lifelong history of regular very strenuous exercise. A control group of 12 healthy sedentary or moderately physically active men (74.5 (2.7) years) was also studied. Design—48 hour ambulatory electrocardiograms were recorded. Cardiac autonomic function was estimated from power spectral analysis of heart rate variability. Maximal oxygen uptake during treadmill exercise testing was 2.91 (0.52) l (41 (7) ml/kg). Results—Nine of 11 athletes had complex ventricular arrhythmias compared with five of 12 controls. Seven athletes but none of the controls had episodes of heart rate below 40 beats/min and two athletes had RR intervals longer than two seconds. Heart rate variability in the athletes was higher than in the controls. Conclusions—Elderly athletes with a lifelong training history seem to have more complex arrhythmias and profound bradyarrhythmias than do healthy elderly controls, which may increase the risk of sudden cardiac death. In contrast, the age related decrease in heart rate variability seems to be retarded, which has a positive prognostic value and may decrease the risk of life threatening ventricular arrhythmias. Keywords: arrhythmias; heart rate variability; athletes; exercise; elderly men
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- Abdalla I. S., Prineas R. J., Neaton J. D., Jacobs D. R., Jr, Crow R. S. Relation between ventricular premature complexes and sudden cardiac death in apparently healthy men. Am J Cardiol. 1987 Nov 1;60(13):1036–1042. doi: 10.1016/0002-9149(87)90348-1. [DOI] [PubMed] [Google Scholar]
- Akselrod S., Gordon D., Ubel F. A., Shannon D. C., Berger A. C., Cohen R. J. Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science. 1981 Jul 10;213(4504):220–222. doi: 10.1126/science.6166045. [DOI] [PubMed] [Google Scholar]
- Bergström B., Lilja B., Rosberg K., Sundkvist G. Autonomic nerve function tests. Reference values in healthy subjects. Clin Physiol. 1986 Dec;6(6):523–528. doi: 10.1111/j.1475-097x.1986.tb00785.x. [DOI] [PubMed] [Google Scholar]
- Berlin J. A., Colditz G. A. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol. 1990 Oct;132(4):612–628. doi: 10.1093/oxfordjournals.aje.a115704. [DOI] [PubMed] [Google Scholar]
- Bigger J. T., Jr, Fleiss J. L., Steinman R. C., Rolnitzky L. M., Schneider W. J., Stein P. K. RR variability in healthy, middle-aged persons compared with patients with chronic coronary heart disease or recent acute myocardial infarction. Circulation. 1995 Apr 1;91(7):1936–1943. doi: 10.1161/01.cir.91.7.1936. [DOI] [PubMed] [Google Scholar]
- Bjerregaard P. Premature beats in healthy subjects 40-79 years of age. Eur Heart J. 1982 Dec;3(6):493–503. doi: 10.1093/oxfordjournals.eurheartj.a061344. [DOI] [PubMed] [Google Scholar]
- Blomqvist C. G., Saltin B. Cardiovascular adaptations to physical training. Annu Rev Physiol. 1983;45:169–189. doi: 10.1146/annurev.ph.45.030183.001125. [DOI] [PubMed] [Google Scholar]
- Cripps T. R., Malik M., Farrell T. G., Camm A. J. Prognostic value of reduced heart rate variability after myocardial infarction: clinical evaluation of a new analysis method. Br Heart J. 1991 Jan;65(1):14–19. doi: 10.1136/hrt.65.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
- De Meersman R. E. Heart rate variability and aerobic fitness. Am Heart J. 1993 Mar;125(3):726–731. doi: 10.1016/0002-8703(93)90164-5. [DOI] [PubMed] [Google Scholar]
- Farrell T. G., Odemuyiwa O., Bashir Y., Cripps T. R., Malik M., Ward D. E., Camm A. J. Prognostic value of baroreflex sensitivity testing after acute myocardial infarction. Br Heart J. 1992 Feb;67(2):129–137. doi: 10.1136/hrt.67.2.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fleg J. L., Kennedy H. L. Cardiac arrhythmias in a healthy elderly population: detection by 24-hour ambulatory electrocardiography. Chest. 1982 Mar;81(3):302–307. doi: 10.1378/chest.81.3.302. [DOI] [PubMed] [Google Scholar]
- Folkow B., Svanborg A. Physiology of cardiovascular aging. Physiol Rev. 1993 Oct;73(4):725–764. doi: 10.1152/physrev.1993.73.4.725. [DOI] [PubMed] [Google Scholar]
- Grimby G., Saltin B. Physiological analysis of physically well-trained middle-aged and old athletes. Acta Med Scand. 1966 May;179(5):513–526. doi: 10.1111/j.0954-6820.1966.tb07968.x. [DOI] [PubMed] [Google Scholar]
- Jensen-Urstad K., Saltin B., Ericson M., Storck N., Jensen-Urstad M. Pronounced resting bradycardia in male elite runners is associated with high heart rate variability. Scand J Med Sci Sports. 1997 Oct;7(5):274–278. doi: 10.1111/j.1600-0838.1997.tb00152.x. [DOI] [PubMed] [Google Scholar]
- Jensen-Urstad K., Storck N., Bouvier F., Ericson M., Lindblad L. E., Jensen-Urstad M. Heart rate variability in healthy subjects is related to age and gender. Acta Physiol Scand. 1997 Jul;160(3):235–241. doi: 10.1046/j.1365-201X.1997.00142.x. [DOI] [PubMed] [Google Scholar]
- Kaijser L., Sachs C. Autonomic cardiovascular responses in old age. Clin Physiol. 1985 Aug;5(4):347–357. doi: 10.1111/j.1475-097x.1985.tb00755.x. [DOI] [PubMed] [Google Scholar]
- Kamath M. V., Fallen E. L. Power spectral analysis of heart rate variability: a noninvasive signature of cardiac autonomic function. Crit Rev Biomed Eng. 1993;21(3):245–311. [PubMed] [Google Scholar]
- Katona P. G., Jih F. Respiratory sinus arrhythmia: noninvasive measure of parasympathetic cardiac control. J Appl Physiol. 1975 Nov;39(5):801–805. doi: 10.1152/jappl.1975.39.5.801. [DOI] [PubMed] [Google Scholar]
- Kleiger R. E., Miller J. P., Bigger J. T., Jr, Moss A. J. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol. 1987 Feb 1;59(4):256–262. doi: 10.1016/0002-9149(87)90795-8. [DOI] [PubMed] [Google Scholar]
- Malik M., Camm A. J. Heart rate variability. Clin Cardiol. 1990 Aug;13(8):570–576. doi: 10.1002/clc.4960130811. [DOI] [PubMed] [Google Scholar]
- Northcote R. J., Canning G. P., Ballantyne D. Electrocardiographic findings in male veteran endurance athletes. Br Heart J. 1989 Feb;61(2):155–160. doi: 10.1136/hrt.61.2.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
- O'Brien I. A., O'Hare P., Corrall R. J. Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function. Br Heart J. 1986 Apr;55(4):348–354. doi: 10.1136/hrt.55.4.348. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Paffenbarger R. S., Jr, Hyde R. T., Wing A. L., Hsieh C. C. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 1986 Mar 6;314(10):605–613. doi: 10.1056/NEJM198603063141003. [DOI] [PubMed] [Google Scholar]
- Pagani M., Lombardi F., Guzzetti S., Rimoldi O., Furlan R., Pizzinelli P., Sandrone G., Malfatto G., Dell'Orto S., Piccaluga E. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res. 1986 Aug;59(2):178–193. doi: 10.1161/01.res.59.2.178. [DOI] [PubMed] [Google Scholar]
- Puig J., Freitas J., Carvalho M. J., Puga N., Ramos J., Fernandes P., Costa O., de Freitas A. F. Spectral analysis of heart rate variability in athletes. J Sports Med Phys Fitness. 1993 Mar;33(1):44–48. [PubMed] [Google Scholar]
- Ruberman W., Weinblatt E., Goldberg J. D., Frank C. W., Chaudhary B. S., Shapiro S. Ventricular premature complexes and sudden death after myocardial infarction. Circulation. 1981 Aug;64(2):297–305. doi: 10.1161/01.cir.64.2.297. [DOI] [PubMed] [Google Scholar]
- Sacknoff D. M., Gleim G. W., Stachenfeld N., Coplan N. L. Effect of athletic training on heart rate variability. Am Heart J. 1994 May;127(5):1275–1278. doi: 10.1016/0002-8703(94)90046-9. [DOI] [PubMed] [Google Scholar]
- Siscovick D. S., Weiss N. S., Fletcher R. H., Lasky T. The incidence of primary cardiac arrest during vigorous exercise. N Engl J Med. 1984 Oct 4;311(14):874–877. doi: 10.1056/NEJM198410043111402. [DOI] [PubMed] [Google Scholar]
