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Updated: Jun 26, 2026
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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Ventricular arrhythmia risk after subarachnoid hemorrhage
J Michael Frangiskakis1, Marilyn Hravnak, Elizabeth A Crago
1Cardiovascular Institute, University of Pittsburgh Medical Center, S572 Scaife Hall, 200 Lothrop Street, Pittsburgh, PA 15213, USA. frangiskakisjm@upmc.edu.
Neurocritical Care
|February 3, 2009
Summary
Ventricular arrhythmias (VA) are common after subarachnoid hemorrhage (SAH) and are linked to increased mortality. While QTc prolongation is frequent, it doesn't always correlate with VA development in SAH patients.
Area of Science:
- Cardiology
- Neurology
- Critical Care Medicine
Background:
- Cardiac complications, including myocardial injury, reduced ventricular function, and ventricular arrhythmias (VA), significantly contribute to morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH).
- Understanding the relationship between electrocardiographic changes like QTc prolongation and the occurrence of VA is crucial for predicting outcomes in SAH patients.
Purpose of the Study:
- To investigate the association between QTc interval prolongation, the incidence of ventricular arrhythmias (VA), and patient survival after aneurysmal subarachnoid hemorrhage (SAH).
Main Methods:
- Electrocardiograms, echocardiograms, and continuous telemetry monitoring were performed on 200 patients with acute aneurysmal SAH.
- Serum electrolytes and cardiac troponin levels were assessed. QTc interval, VA occurrence, and all-cause mortality were analyzed.
Main Results:
- QTc prolongation (>= 470 ms) was observed in 38% of subjects initially, with a significant decrease on follow-up. VA occurred in 14% of patients.
- While 52% of patients with VA had QTc prolongation, multivariate analysis identified increasing age, stroke severity, decreasing heart rate, and absence of specific antihypertensive use as significant predictors of VA.
- Subjects with VA experienced significantly higher 3-month all-cause mortality (37%) compared to those without VA (16%).
Conclusions:
- QTc prolongation and arrhythmias are frequent findings post-SAH, but arrhythmias are not consistently associated with QTc prolongation.
- The presence of ventricular arrhythmias (VA) serves as a significant indicator of increased mortality risk in patients following subarachnoid hemorrhage.
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