ECG attenuation phenomenon with advancing age

What is it about?

With advancing age, the conduction systemand heartmuscle cells undergo degenerative alterations affecting the electrocardiographic (ECG) parameters. The goal of the study is to determine the effect of age on ECG parameters. Are these changes due to a ‘normal aging’ or are they indicative to a ‘heart disease’? Italian Longitudinal Study on Aging (ILSA) database has been created to evaluate physiologic and pathologic modifications connected with aging. Standard 12-leads ECG recordings (10 s, 500 Hz) have been taken twice in a period of three years. The database consists of 890 individuals aged 65–84 years. Analysis of changes has been done also in two groups of individuals in ILSA database – with and without cardiovascular abnormality. This analysis showed a nearly equal age-related change in both groups. ECG attenuation phenomenon is more common in males, and it is not significant in females. This attenuation is manifested significantly also in healthymale group, suggesting geriatric changes of “normal aging”. Nevertheless, some cardiovascular diseases, such as arrhythmias and hypertension, may have a strong influence on the QRS attenuation, and this supports the open question of the clinical relevance of the phenomenon. ECG attenuation phenomenon is more manifested in younger individuals and occurs independently of body mass. ECG attenuation phenomenon is a significant fact, and therefore it should be considered in any serial ECG study, for example in the ECG analysis for human identification.

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Why is it important?

Geriatric changes of the ECG are observed and reported in the literature. The analysis of serial changes, 3 years apart, in a group of individuals with/without cardiovascular diseases of the ILSA database showed significant age-related changes. The main ECG alteration that we observed was a reduction in the amplitudes of the QRS- and T-waves, referred as ‘ECG attenuation phenomenon’. This phenomenon was present in males and was insignificant in females. Significant ECG attenuation in male healthy group suggests geriatric changes to “normal aging”, although some cardiovascular diseases may have a strong influence on the QRS attenuation.

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