Age-related changes in electrophysiology of the atrioventricular node and electrocardiographic manifestations

Atrioventricular conduction time increases with age, both due to atrioventricular nodal and His-Purkinje system changes. In the ageing process, structural and cellular electrophysiological changes as well as altered autonomic drive and negative chronotropic drugs play a role, The clinical differentiation between the atrioventricular node and the His bundle as a cause of diminished atrioventricular transmission is often relevant with respect to pharmacological and pacing strategies, However, it may appear irrelevant in the elderly in whom the atrioventricular conduction axis is mostly affected more diffusely, especially if underlying heart disease is present. One specific effect of ageing is the emergence of atrioventricular nodal tachycardias, where ageing of the atrioventricular node may set the stage for re-entry. (C) Rapid Science Publishers.