Study of electrocardiographic patterns in clinically normal persons above sixty years of age

Golwalkar J. K., Prashant T. Dond, Rayate V. S., Anand B. Mugadlimath


Background: The study was done to analyse the electrocardiographic patterns in the asymptomatic and clinically normal subjects over the age of sixty years and also to compare and discuss the significant of electrocardiographic changes noted in these persons with earlier observations quoted in the literature.

Methods: The study was carried out during a period of one year and a total 283 persons were examined 33 persons who were not fulfilling the criteria mentioned were excluded. Thus 250 clinically normal persons above the age of 60 years comprised the study group.

Results: 30% of males had a vertical heart while in females the predominant position was Intermediate (36%). 15.87% males and 19.35% females showed an anticlockwise rotation and majority of the subjects showed a normal position of the heart. Only 3 males and 4 females showed abnormal left axis deviation and 3 males and 1 female exhibited right axis deviation. Small P wave were observed in 5 males (3.96%) and 4 females (3.22%) while tall P waves were noted in 6 males (4.67%) and 2 females (1.61%). None of the subjects exhibited P-R interval less than 0.12 sec. More than 0.20 sec. was noted in 3 males. In a total of 76 persons (30.40%) QTC was prolonged, 42 were males (33.33%) and 34 females (26.77%).

Conclusions: Parameters such as position of the heart (rotation, P wave duration and amplitude, P-R interval and QRS duration etc) were within defined normal limits, except the prolongation of QTC observed in 30.40% of persons. A negative history and clinical examination of an old person is a fair indication of his normal cardiovascular status and slight deviation of an electrocardiogram need not arouse any undue anxiety either in the physician or the patient.


ECG, Old age, P-R interval, QTC duration

Full Text:



Pathak, JD. Our elderly. Medical Research Centre Bombay Hospital Trust Bombay, 2012. PP. 26, 69 123-126.

Olamoyegun OM, Ogunmola OO, Oladosu Y, Kolawole BA. Prevalence, variant and determinant of electrocardiographic abnormalities amongst elderly Nigeria. Journal of medicine and medical sciences. 2013;4:324-8.

McNamara RJ. A study of the electrocardiogram

in persons over seventy. Geriatrics. 2012;4:150-60.

Goldman MJ. Principal of clinical electrocardiography. 10th Edition. Lange Medical Publications. 1979. PP. 24-27, 58-73.

Assantachai P, Panchavinnin P, Pisalsarakij D. An electrocardiographic survey of elderly Thai people in the rural community. J Med Assoc Thai. 2002;85:1273-9.

Kissin and Others : Nomogram for rate correction of QT interval. Am.Heart J. 35:990, 1948; Quoted by Goldman, M.J. (1999) No. 11.

Jelliffe DB. Assessment of Nutritional Status of the Community. World Health Organisation. PP. 238-242, 2006.

Simonson E, Keys A. The effects of age and body weight on the electrocardiogram of healthy Men. Circulation. 1952;6:749-61.

Blackburn H, Vasquez CL, keys A. The aging electrocardiogram. A common aging process or latent coronary artery disease. Am. J.Cardiology. 1967;2:618-27.

Simonson E, Keys A. The effects of age on mean QRS and T vectors. Circulation. 1956;14:100-4.

Michie, I. Electrocardiographic changes in elderly. Geront. Clin . 1990;12:193-202.

Mihalick, M. J., Fisch, C. : electrocardiographic Findings in the aged. Am. Heart J. 87: 11-128,1994.

Simonson, E. The effects of age on electrocardiogram. Am. J. Cardiology. 29:64-73, 1972.

Ostrander, L.D. : Bundle branch block. An epidemiologic study. Circulation 30:872-880, 1964.

Jensen, J., Smith, M. Cartwright, E. D. The Electrocardiogram in late middle life. Am. Heart J. 7:718-724, 1932.

Taran, L.M., Kaye, M. Electrocardiographic studies in old age. Ann. of Int.Med. 20:954-960, 1944.

Gelman I, Brown S. Electrocardiographical characterization of the heart in old age and in childhood. Acta Med. Scand.91: 378-396, 1937.

Pipeberger, H.V., Schiederman, M.A. and Klingman, J.P. : The love at first sight in research. Circulation 38:822-830, 1968.

Keys, A., Aravani, C., Blackburn, H.W. et al : Epidemiological studies related to coronary Heart disease characteristic of men aged 40 -59 in 7 contries. Acta Med.Scand. Suppl. 1967;460(55):276.

Simonson E, Blackburn H Jr., Puchner TC, Eisenberg P, Ribeiro F, Meja M. Sex difference in the electrocardiogram. Circulation. 1960;22:598-601.

Friedberg CK. Disease of Heart 3rd Ed. Philadelphia and London, W.B. Saunders Company, 1966. Pg.601.

Schlomka, G. : Ueber die Beziehungen. Zwischen Muskelmassenverhaltnis der Herakammern and Ekg. Typ. Deutsches Arch. Klin. Med. 1948;193:555.

Lipman, B.S., Massie, E., Kleiger, R.E. : Clinical Scalar electrocardiography. Year Book Medical Publishers, Chicago. PP158, 267. 1949.