Are cardiac arrhythmias important in stroke?

Ambulatory electrocardiography was performed on 21 consecutive acute stroke patients on the day of admission and 14 and 42 days later. There was no statistically significant difference in cardiac arrhythmias between stroke patients and a group of age- and sex-matched controls. There was considerable variation in the frequency of cardiac arrhythmias on each day but none of the arrhythmias was associated with a sudden deterioration in the condition of the patients and no arrhythmias produced symptoms in either the stroke or the control groups. Fourteen per cent of stroke patients had an associated acute myocardial infarction and 57% had a history of previous heart disease. While a history of previous heart disease or the occurrence of major ventricular arrhythmias were associated with an increased six-week mortality rate, routine continuous monitoring of cardiac rhythm would not appear to be of value in acute stroke.