J Med Assoc Thai 2002; 85 (12):1273

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An Electrocardiographic Survey of Elderly Thai People in the Rural Community
Assantachai P Mail, Panchavinnin P , Pisalsarakij D

Electrocardiographic findings in the elderly reflect both common cardiac diseases and physio-
logic ageing change. This cross-sectional population-based study explored the prevalence of various
abnormalities in the electrocardiograms of active older people and those who are free from any cardiac
pathology and determined their relationship to age and gender in a rural area of Thailand. Nine hundred
and sixty three people aged 60 years or more were recruited. The electrocardiographic prevalence of
ischemic heart disease, atrial fibrillation, left axis deviation and conduction defect were 5.5 per cent,
2.2 per cent, 2.5 per cent and 3.1 per cent respectively. After excluding diseases potentially affect-
ing the heart, the prevalence of atrial fibrillation, left axis deviation and conduction defect decreased
to 1.3 per cent, 2.0 per cent and 2.2 per cent. The prevalence of atrial fibrillation and ischemic heart
disease were significantly less (p
=
O.oi5 and 0.003) in the 80+ year old group. Regarding gender
difference, only left axis deviation was found significantly more frequently in older men with an odds
ratio of 5.23 (95% confidence interval, 1.28-30.29) in those who were free from diseases potentially
affecting the heart.
In conclusion : Atrial fibrillation should not be regarded as degenerative change, but the result
of cardiac pathology instead. The most common electrocardiographic abnormality in normal older
men was left axis deviation and was found consistently more often than in older women. Therefore,
it is appropriate to investigate for any reversible causes of atrial fibrillation while it is not so for left
axis deviation in older men.
Key word : Thai Elderly Person, Rural Community, Electrocardiography

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