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Abnormalities on ECG and telemetry predict stroke outcome at 3 months
Hanne Christensen1, Anders Fogh Christensen, Gudrun Boysen
1Dept. of Neurology, Bispebjerg Hospital, University of Copenhagen 2400 Copenhagen NV, Denmark. hc04@bbh.hosp.dk
Journal of the Neurological Sciences
|June 7, 2005
Summary
Electrocardiogram (ECG) abnormalities are common in acute stroke patients, affecting 60% with cerebral infarction and 50% with intracerebral hemorrhage. These findings, including atrial fibrillation and ST-depression, can predict 3-month mortality risk.
Area of Science:
- Cardiology
- Neurology
- Medical Diagnostics
Background:
- Electrocardiograms (ECG) are vital for monitoring patients with acute stroke.
- Limited evidence exists on the prevalence and prognostic impact of ECG findings in acute cerebral infarction and intracerebral hemorrhage (ICH).
Purpose of the Study:
- To investigate the prevalence of ECG abnormalities in patients with acute cerebral infarction, ICH, and transient ischemic attack (TIA).
- To determine the prognostic impact of ECG findings on 3-month mortality in these patient groups.
Main Methods:
- Analysis of data from 692 patients with acute cerebral infarction, 155 with ICH, and 223 with TIA, admitted within 6 hours of symptom onset.
- A 12-lead ECG was performed on admission, with telemetry monitoring for the first 12-24 hours.
Main Results:
- ECG abnormalities were frequent: 60% in cerebral infarction, 50% in ICH, and 44% in TIA.
- In ischemic stroke, atrial fibrillation, AV block, ST-elevation, ST-depression, and inverted T-waves predicted 3-month mortality.
- In ICH, sinus tachycardia, ST-depression, and inverted T-waves predicted poor outcomes. Rapid heart rate also predicted mortality.
Conclusions:
- ECG abnormalities are common in acute stroke patients.
- Specific ECG findings are significant predictors of 3-month mortality in both ischemic stroke and ICH.