心律失常在老年人心血管疾病诊治中占有重要地位。其发生率高,临床特征和治疗常不同于一般成年人,且往往作为老年人危重症状群的先兆,严重地威胁老年人的健康。老年人心脏的病理生理特点随着老年期的到来,老年人心血管系统功能逐渐低下,心肌细胞β受体数目减少,以及纤维中神经递质酶活性减低使衰老的心脏和血管系统对儿茶酚胺的敏感性降低,窦房结的起搏功能减退,迷走神经张力增强而使窦房结的自律性受到抑制,心率趋于缓慢。Thery等发现随年龄增长,窦房结内的起搏细胞减少,且有空泡形成和核破坏,纤维组织增生,此种改变使窦房结和房室结变性。当病变波及整个心房,或同时侵入房室束、心脏传导系统时则会影响正常冲动形成和传导。电生理研究证实老年人的心肌易感性和应激性均有增加而传导性相对减慢,随年 Arrhythmia plays an important role in the diagnosis and treatment of cardiovascular diseases in the elderly. Its high incidence, clinical features and treatment are often different from the average adult, and often as a warning sign of the elderly in critical conditions, a serious threat to the health of the elderly. Pathophysiology of the Elderly With the advent of old age, the cardiovascular system of the elderly is gradually reduced, the number of beta-receptors in cardiomyocytes is decreased, and the activity of neurotransmitter enzymes in the fiber is reduced. The aging of the heart and vasculature on catecholamines Sensitivity decreased, sinus node pacing dysfunction, increased vagal tone so that sinus node autonomic inhibition, heart rate tends to be slow. Thery found that with age, the pacemaker cells in the sinus node decreased, and the formation of vacuoles and nuclear damage, fibrous tissue proliferation, such changes in the sinus node and atrioventricular node degeneration. When the lesion affects the entire atrium, or at the same time invading the atrioventricular bundle, the heart’s conduction system can affect normal impulse formation and conduction. Electrophysiological studies confirmed that the elderly susceptibility and stress increased myocardial conductivity has been relatively slow, with the years