Analysis of epidemiological characteristics and psychopsychological factors of arrhythmia in the elderly

• DOI: 10.5498/wjp.v15.i4.100281
• Publication Date: 2025-03-25T05:13:51Z
• Authors: Hong-Wei Zhang; Guo-Dong Chang; Xue-Meng Liu; Hui Gao; Xiu-Dan Xu; Su-Ying Lv

BACKGROUND Irregular heart rhythms are a primary manifestation of cardiovascular disease, considerably contributing to global morbidity and mortality rates. Moreover, patients with cardiac arrhythmias often experience a higher prevalence of sleep disorders, anxiety, and depression owing to various factors. AIM To investigate the epidemiological characteristics and psychological factors associated with arrhythmia in the elderly and to establish a theoretical foundation for its prevention and treatment in older adults. METHODS A retrospective analysis was performed on 169 elderly patients admitted to the Shangqiu First People’s Hospital from December 2022 to December 2023. All subjects underwent 24-hour electrocardiogram monitoring to record heart rate, heart rate variability, and 24-hour ambulatory electrocardiogram data. Additionally, patients’ medical records were reviewed to gather information on their general condition, including age, gender, underlying diseases, and other relevant factors. Patients were divided into four groups based on their Hamilton Anxiety (HAMA) and Hamilton Depression Rating Scale (HAMD) scores: Group A (HAMA scores ≥ 7), Group B (HAMD scores ≥ 7), Group C (both HAMA and HAMD scores ≥ 7), and Group D (HAMA and HAMD scores < 7). Psychological factors such as depression, anxiety, sleep status, and quality of life were analyzed. Pearson correlation was used to examine the relationship between scores from the Pittsburgh Sleep Quality Index (PSQI), HAMA/HAMD scales, and the Short Form 36-item Health Survey (SF-36) with the presence of arrhythmia. RESULTS Among the 169 patients, 87 (51.5%) had concurrent arrhythmia. Atrial arrhythmias constituted the largest proportion at 34.8% (30 out of 87), followed by sinus tachycardia at 24.1% (21 out of 87), and ventricular arrhythmias at 9.2% (8 out of 87). Factors such as advanced age, coronary heart disease, hypertension, smoking, exposure to secondhand smoke, and residing in rural areas significantly increased the risk of developing arrhythmia. There was a statistically significant difference between the two groups regarding PSQI, HAMA-14, HAMD-17, and SF-36 scores. Pearson correlation analysis revealed that PSQI, HAMA-14, and HAMD-17 scores were positively correlated with arrhythmia in the elderly, while the SF-36 score was negatively correlated. The anxiety, depression, and combined anxiety–depression groups exhibited significantly higher PSQI, HAMA-14, and HAMD-17 scores compared to the nonanxiety and non-depression group. CONCLUSION Arrhythmia among the elderly is primarily found in individuals with advanced age and existing health conditions. It is also linked to psychological factors such as depression, anxiety, reduced quality of life, and sleep disturbances.