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[Studies of arrhythmia incidence and heart rate variability in patients suffering from cerebral stroke]
M Negrusz-Kawecka1, M Kobusiak-Prokopowicz
1Katedra i Klinika Kardiologii AM, Wrocławiu.
Insights
Patients with cerebral stroke experience more cardiac arrhythmias and reduced heart rate variability (HRV) compared to those with hypertension alone. This highlights the significant cardiac impact of stroke.
Area of Science:
- Cardiology
- Neurology
- Medical Diagnostics
Background:
- Cerebral stroke is associated with electrocardiographic changes, including arrhythmias and potential circulatory arrest.
- Holter monitoring is a standard method for assessing arrhythmias, cardiac ischemia, and autonomic nervous system function.
Purpose of the Study:
- To evaluate the incidence of cardiac arrhythmias and heart rate variability (HRV) in patients with recent cerebral stroke.
- To compare cardiac autonomic function between stroke patients and a control group with primary hypertension.
Main Methods:
- 36 patients with recent cerebral stroke (confirmed by CT scan) and 65 hypertensive controls underwent 24-hour Holter monitoring.
- ECG data were analyzed using the Optima Jet system, with visual verification.
- Heart rate variability (HRV) was calculated over 24 hours, and separately for day and night periods.
Main Results:
- Patients with cerebral stroke exhibited a higher frequency of premature supraventricular beats, ventricular couplets, and non-sustained ventricular tachycardia compared to controls.
- Stroke patients demonstrated significantly lower 24-hour heart rate variability (HRV).
Conclusions:
- Recent cerebral stroke is linked to increased cardiac arrhythmias and impaired autonomic nervous system function, indicated by reduced HRV.
- These findings underscore the importance of cardiac monitoring in stroke patients.
Abstract:
Patients with cerebral stroke develop electrocardiographic changes concerning the period of ventricular muscle repolarization and cardiac arrhythmias, which may results in the possibility of acute circulatory arrest. ECG monitoring by means of Holter method provides not only information concerning arrhythmias, episodes of ischaemia of the cardiac muscle, but it is also a recognised and generally accepted method of investigation of the autonomic system. The aim of the study was to assess the incidence of arrhythmias and heart rate variability in patients suffering from recent cerebral stroke. The studies involved 36 patients, in that 22 women (mean age 67.7 +/- 7.2 years) and 14 men (mean age 66.5 +/- 11.3 years) within first 24 hours after cerebral stroke confirmed by computerised tomography (CT). One the basis of CT scan haemorrhagic stroke was diagnosed in 7 patients and ischaemic stroke, after ruling out haemorrhagic stroke and neurological consultations, in 29 patients. Moreover, all patients revealed hypertension, 12 of them mild degree (1 degree), and 21 of moderate degree (2 degrees), and 3 of severe degree (3 degrees). The control group comprised 65 patients suffering from primary hypertension without concomitant cerebral stroke, matching the study group as to sex and age as well as the degree of hypertension. All of them were submitted to 24-hour Holter monitoring on tape by means of 3-channel registrator MR45, analysis of ECG tracings was carried out according to Optima Jet system manufactured by Oxford. In order to facilitate further analysis, the automatic recording was verified visually and next heart rate variability (HRV) was estimated within 24 hours and separately for day hours 6:00-22:00 and night hours 22:00-6:00. In comparison to patients with hypertension, but without stroke, subjects with hypertension and accompanying cerebral stroke more often reveal premature supraventricular beats, pairs of ventricular beats as well as episodes of nonsustained ventricular tachycardia; they also reveal lower 24-hours heart rate variability.