In aged patients, sinus bradycardia often reflects progressive diffuse conduction system disease that may eventually require pacemaker insertion.
May prompt serial monitoring for conduction progression in elderly bradycardia; leaves open prospective validation of pacemaker timing.
In the aged, sinus bradycardia represents the sinus-node-dysfunction component of diffuse conduction system disease associated with coronary and cerebral arteriosclerosis. Findings are presented on 15 patients whose ages ranged from 69 to 93 years at the time of admission to a home for the aged. They remained under observation (with electrocardiographic data) for from less than 1 year up to 18 years. The findings illustrate the evolution of conduction system abnormalities, including sinus node dysfunction, occurring either as an initial or an interval event. These abnormalities represent positive indications for pacemaker insertion in the aged.
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George Friedman (1978) studied this question.
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