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Prevalence and characterization of ECG abnormalities after intracerebral hemorrhage

Maurits D R van Bree1, Yvo B W E M Roos, Ivo A C van der Bilt

  • 1Department of Neurology, Academic Medical Centre Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

Neurocritical Care
|October 9, 2009
PubMed

Insights

Electrocardiogram (ECG) abnormalities are common in patients with intracerebral hemorrhage (ICH). QTc prolongation, a frequent finding, is linked to insular cortex involvement and hydrocephalus.

Area of Science:

  • Neurology
  • Cardiology
  • Medical Imaging

Background:

  • Electrocardiographic (ECG) abnormalities are recognized in ischemic stroke and subarachnoid hemorrhage.
  • Systematic investigation of ECG changes in intracerebral hemorrhage (ICH) is limited.

Purpose of the Study:

  • To determine the prevalence and types of ECG abnormalities in patients with ICH.
  • To explore associations between ECG findings and neurological/radiological parameters.

Main Methods:

  • Analysis of ECGs from consecutive non-traumatic, intraparenchymal ICH patients within 2 days of hemorrhage.
  • Review of admission cranial CT scans for radiological parameters.
  • Prospective registration of baseline information in the AMC Stroke Register.

Main Results:

  • 81% of ICH patients exhibited one or more ECG abnormalities.
  • Most common: QTc prolongation (36%), ST-T changes (23%), sinus bradycardia (16%).
  • QTc prolongation associated with insular cortex involvement and intraventricular blood/hydrocephalus.

Conclusions:

  • ECG abnormalities are prevalent in ICH patients.
  • QTc prolongation may indicate insular involvement, intraventricular blood, and hydrocephalus.
  • Further research with continuous monitoring is needed to link ECG changes to patient outcomes.
Abstract

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