A NEW study has shown that age significantly increases the risk of both atrial and ventricular arrhythmias, while higher fitness levels may offer protection against atrial ectopy.
Researchers examined 1,151 asymptomatic adults without structural heart disease who underwent 24-hour Holter monitoring and exercise stress testing between 2010 and 2022. Participants were stratified by ectopic burden, with those above the median or displaying complex arrhythmias, including atrial fibrillation (AF), supraventricular tachycardia (SVT), or non-sustained ventricular tachycardia (NSVT), classified as having high atrial or ventricular ectopic burden. The investigators aimed to clarify the role of age and fitness in arrhythmic risk among otherwise healthy individuals.
Of the 1,010 subjects included in the final analysis (mean age 52 years, 12% female), SVT was present in 32%, AF in 4%, and NSVT in 6%. Univariate analysis showed high atrial ectopic burden (AEB) was associated with older age, male sex, hypertension, lower estimated glomerular filtration rate (eGFR), and reduced fitness, while high ventricular ectopic burden (VEB) was linked to older age and reduced eGFR. In multivariable models, age emerged as a strong independent risk factor for both AEB (odds ratio [OR]: 1.08, 95% CI: 1.06–1.11; p<0.001) and VEB (OR: 1.04, 95% CI: 1.02–1.06; p<0.001). Fitness was protective against AEB, with lower fitness levels increasing risk (OR: 1.52, 95% CI: 1.11–2.04; p=0.008). Declining renal function had a modest but consistent association with both AEB and VEB. Graphical analyses indicated a steady age-related rise in atrial arrhythmias, while ventricular arrhythmias followed a more variable upward trajectory.
The findings suggest that ageing exerts a strong influence on arrhythmic risk even in asymptomatic, otherwise healthy individuals, while maintaining fitness may counteract atrial vulnerability. Preventive cardiology strategies may therefore benefit from incorporating age-based arrhythmia screening alongside lifestyle approaches to preserve fitness.
Reference
Moses A et al. Aging and arrhythmias: identifying early risk factors in healthy individuals. ESC Congress 2025, 29 August-1 September, 2025.
