As people grow older, the heart undergoes various changes that can affect its ability to maintain a stable rhythm, making older adults more at risk of developing heart rhythm disorders (arrhythmias).
Although these conditions often occur without symptoms, dr Rerdin Julario, SpJP SubSp Arr (K) FIHA FAsCC of Mayapada Hospital Surabaya emphasises the importance of recognising the types of arrhythmia commonly experienced by elderly patients.
First, bradyarrhythmia, a condition in which the heart beats more slowly, pauses briefly, or becomes irregular due to damage to the parts that regulate the heartbeat (the SA node and AV node).
Another common type is atrial fibrillation (AF), an irregular heartbeat caused by electrical disturbances in the upper chambers of the heart. This condition may lead to the formation of blood clots and increase the risk of stroke. Treatment usually involves anti-arrhythmic medication to regulate the heart rhythm and anticoagulants to prevent blood clotting, along with regular monitoring.
There is also ectopic arrhythmia, which refers to extra heartbeats originating either in the upper part of the heart (supraventricular) or the lower part (ventricular). This occurs due to additional electrical signals from hardened tissue (fibrosis), causing palpitations or a feeling of discomfort in the chest.
Older adults may also experience ventricular tachycardia, a condition in which the heart beats very rapidly due to disruption of the heart’s electrical flow. This may be caused by several conditions, such as blocked blood vessels (coronary heart disease), reduced blood flow to the heart muscle (myocardial ischaemia), or weakened pumping ability of the heart (ventricular dysfunction). If left untreated, this condition may lead to serious electrical disturbances and even cardiac arrest, which can be life-threatening.
However, arrhythmia in older adults can often be prevented through routine heart examinations using an ECG.
“In addition, if an abnormality is detected, the doctor may carry out further tests such as Holter monitoring, an event recorder, or an electrophysiology study of the cardiac conduction system. If the detected arrhythmia is severe, the doctor may perform ablation to stop abnormal electrical signals or implant a permanent pacemaker, depending on the patient’s age, overall health, and life expectancy,” explained dr Rerdin.
It is also important to maintain light physical activity and a healthy diet to support heart health. Family members should be involved in monitoring symptoms such as palpitations, fainting, or sudden shortness of breath so that treatment can be provided immediately and the risk of serious complications can be reduced.
Considering the importance of arrhythmia prevention in older adults, comprehensive heart examination and treatment are equally essential. Mayapada Hospital Surabaya provides a Heart & Vascular Center built on three main pillars. The first, Emergency Excellence, is delivered through the Chest Pain Unit, which focuses on the evaluation, diagnosis, and early treatment of heart-related complaints such as chest pain, whether caused by cardiac or non-cardiac conditions, with free initial examination if no cardiac indication is found, and further referral through Cardiac Emergency, supported by specialist and subspecialist doctors on site 24 hours a day.
The second pillar, Advanced Treatment, covers vascular services, heart rhythm disorders (arrhythmia), and structural heart abnormalities such as valve disease using advanced approaches. The third pillar, Team-Based Management, ensures that clinical decisions and treatment plans are determined through active collaboration in the Cardiac Board, involving cardiologists, cardiothoracic surgeons, cardiovascular anaesthetists, and paediatric heart specialists.
This multidisciplinary approach helps determine the most appropriate treatment, ranging from Coronary Angiography (CAG) and Percutaneous Coronary Intervention (PCI), including complex PCI, to the management of valve and vascular disorders, heart rhythm problems, and advanced heart failure therapy supported by the latest mechanical pump device, the Left Ventricular Assist Device (LVAD).
The service also includes a Cardiac Advisor who assists patients and families throughout the entire process, from initial consultation to recovery, ensuring that every medical decision is clearly understood, treatment runs smoothly, and any concerns are addressed quickly and accurately.
Complete information about cardiac services across all Mayapada Hospital units is available through the Health Articles & Tips feature in MyCare, as well as the Personal Health feature connected to Google Fit and Health Access, which can be used to monitor heart rate, calories, steps, and Body Mass Index (BMI).