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. 1999;26(4):258–263.

Cardiac arrhythmia at high altitude: the progressive effect of aging.

J K Alexander 1
PMCID: PMC325660  PMID: 10653252

Abstract

To evaluate the effects of aging on cardiac rhythm at high altitude, I wore a Holter monitor at age 75 during a climb to 5,100 m on Mt. Kilimanjaro, then compared findings with those from my climb to 5,895 m at age 65. Holter leads were placed to identify left or right ventricular source of ectopy, and on the 2nd ascent arterial oxygen saturation was monitored by finger oximetry. Sea-level testing revealed no evidence of cardiac disease. During ascent from 4,710 to 5,100 m, when arterial oxygen saturation reached 70%, heart rate was higher (123 vs 116 beats per minute), and frequency of left ventricular premature complexes was greater (56 vs 50 per hour) than on the earlier ascent. Nine 3- to 5-complex runs of left ventricular tachycardia were recorded during climbing, resting, or sleeping, and there was 1 run of 14 complexes at 250 beats per minute during the climb near 5,100 m. These observations suggest that aging increases sympathetic response or sensitivity, or both, to hypoxia during exercise, and even during sleep. Also, our focus should perhaps be on sympathetic stimulation rather than on pulmonary hypertension as a cause of arrhythmia in unacclimatized older persons at high altitude.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akhtar M., Bandopadhaya P., Chatterjee P. C., Krishnamurti S. Electrocardiographic changes under moderate hypoxia. Indian Heart J. 1979 Nov-Dec;31(6):353–358. [PubMed] [Google Scholar]
  2. Alexander J. K. Age, altitude, and arrhythmia. Tex Heart Inst J. 1995;22(4):308–316. [PMC free article] [PubMed] [Google Scholar]
  3. Burtscher M., Philadelphy M., Likar R. Sudden cardiac death during mountain hiking and downhill skiing. N Engl J Med. 1993 Dec 2;329(23):1738–1739. doi: 10.1056/NEJM199312023292315. [DOI] [PubMed] [Google Scholar]
  4. Burtscher M., Philadelphy M., Nachbauer W., Likar R. The risk of death to trekkers and hikers in the mountains. JAMA. 1995 Feb 8;273(6):460–460. doi: 10.1001/jama.1995.03520300030031. [DOI] [PubMed] [Google Scholar]
  5. Burtscher M. Time-dependent SCD risk during mountain hiking. Circulation. 1994 Jun;89(6):2948–2949. doi: 10.1161/01.cir.89.6.2948. [DOI] [PubMed] [Google Scholar]
  6. Das B. K., Tewari S. C., Parashar S. K., Akhtar M., Grover D. N., Ohri V. C., Dutta S. K., Chatterjee J. C. Electrocardiographic changes at high attitude. Indian Heart J. 1983 Jan-Feb;35(1):30–33. [PubMed] [Google Scholar]
  7. Dill D. B., Hillyard S. D., Miller J. Vital capacity, exercise performance, and blood gases at altitude as related to age. J Appl Physiol Respir Environ Exerc Physiol. 1980 Jan;48(1):6–9. doi: 10.1152/jappl.1980.48.1.6. [DOI] [PubMed] [Google Scholar]
  8. Fedida D., Braun A. P., Giles W. R. Alpha 1-adrenoceptors in myocardium: functional aspects and transmembrane signaling mechanisms. Physiol Rev. 1993 Apr;73(2):469–487. doi: 10.1152/physrev.1993.73.2.469. [DOI] [PubMed] [Google Scholar]
  9. Fleg J. L., Tzankoff S. P., Lakatta E. G. Age-related augmentation of plasma catecholamines during dynamic exercise in healthy males. J Appl Physiol (1985) 1985 Oct;59(4):1033–1039. doi: 10.1152/jappl.1985.59.4.1033. [DOI] [PubMed] [Google Scholar]
  10. 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]
  11. Groves B. M., Reeves J. T., Sutton J. R., Wagner P. D., Cymerman A., Malconian M. K., Rock P. B., Young P. M., Houston C. S. Operation Everest II: elevated high-altitude pulmonary resistance unresponsive to oxygen. J Appl Physiol (1985) 1987 Aug;63(2):521–530. doi: 10.1152/jappl.1987.63.2.521. [DOI] [PubMed] [Google Scholar]
  12. Harris C. W., Hansen J. E. Electrocardiographic changes during exposure to high altitude. Am J Cardiol. 1966 Aug;18(2):183–190. doi: 10.1016/0002-9149(66)90031-2. [DOI] [PubMed] [Google Scholar]
  13. JACKSON F., DAVIES H. The electrocardiogram of the mountaineer at high altitude. Br Heart J. 1960 Nov;22:671–685. doi: 10.1136/hrt.22.5.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Malconian M., Hultgren H., Nitta M., Anholm J., Houston C., Fails H. The sleep electrocardiogram at extreme altitudes (Operation Everest II) Am J Cardiol. 1990 Apr 15;65(15):1014–1020. doi: 10.1016/0002-9149(90)91006-r. [DOI] [PubMed] [Google Scholar]
  15. Malconian M., Rock P., Hultgren H., Donner H., Cymerman A., Groves B., Reeves J., Alexander J., Sutton J., Nitta M. The electrocardiogram at rest and exercise during a simulated ascent of Mt. Everest (Operation Everest II). Am J Cardiol. 1990 Jun 15;65(22):1475–1480. doi: 10.1016/0002-9149(90)91358-d. [DOI] [PubMed] [Google Scholar]
  16. Milledge J. S. ELECTROCARDIOGRAPHIC CHANGES AT HIGH ALTITUDE. Br Heart J. 1963 May;25(3):291–298. doi: 10.1136/hrt.25.3.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Pollard A., Clarke C. Deaths during mountaineering at extreme altitude. Lancet. 1988 Jun 4;1(8597):1277–1277. doi: 10.1016/s0140-6736(88)92093-4. [DOI] [PubMed] [Google Scholar]
  18. Rowell L. B., Johnson D. G., Chase P. B., Comess K. A., Seals D. R. Hypoxemia raises muscle sympathetic activity but not norepinephrine in resting humans. J Appl Physiol (1985) 1989 Apr;66(4):1736–1743. doi: 10.1152/jappl.1989.66.4.1736. [DOI] [PubMed] [Google Scholar]
  19. Seals D. R., Johnson D. G., Fregosi R. F. Hypoxia potentiates exercise-induced sympathetic neural activation in humans. J Appl Physiol (1985) 1991 Sep;71(3):1032–1040. doi: 10.1152/jappl.1991.71.3.1032. [DOI] [PubMed] [Google Scholar]
  20. Shi Z. Y., Ning X. H., Zhu S. C., Zhao D. M., Huang P. G., Yang S. Y., Wang Y., Dong Z. S. Electrocardiogram made on ascending the Mount Qomolangma from 50 m a. s. l. Sci Sin. 1980 Oct;23(10):1316–1325. [PubMed] [Google Scholar]
  21. Vestal R. E., Wood A. J., Shand D. G. Reduced beta-adrenoceptor sensitivity in the elderly. Clin Pharmacol Ther. 1979 Aug;26(2):181–186. doi: 10.1002/cpt1979262181. [DOI] [PubMed] [Google Scholar]
  22. Wit A. L., Rosen M. R. Pathophysiologic mechanisms of cardiac arrhythmias. Am Heart J. 1983 Oct;106(4 Pt 2):798–811. doi: 10.1016/0002-8703(83)90003-0. [DOI] [PubMed] [Google Scholar]
  23. del Balzo U., Rosen M. R., Malfatto G., Kaplan L. M., Steinberg S. F. Specific alpha 1-adrenergic receptor subtypes modulate catecholamine-induced increases and decreases in ventricular automaticity. Circ Res. 1990 Dec;67(6):1535–1551. doi: 10.1161/01.res.67.6.1535. [DOI] [PubMed] [Google Scholar]

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