Cardiac arrhythmias in acute stroke

Cardiac arrhythmias were more frequent (p less than 0.001) in 312 stroke patients admitted to an intensive care stroke unit, than in 92 patients admitted to the unit and subsequently found not to have strokes. This significant difference remained when a stroke subgroup and the non-stroke group were matched for age, sex and duration of stay in the unit (P less than 0.005). Hypertension and hypertensive cardiac disease were more common in the stroke than in the non-stroke patients (P less than 0.001). Ectopic beats and atrial fibrillation, as well as other arrhythmias, were most frequent in patients with cerebral hemisphere infarction, and patients with hemispheric lesions had significantly more arrhythmias than those with brain stem lesions (P less than 0.05). The arrhythmias were rarely (2%) responsible for hemodynamic ischemic cerebrovascular lesions, but may have been associated with cerebral embolism in up to 17% of cases. The cardiac arrhythmias appeared to have little influence on the course of the subsequent recovery from stroke. Although these arrhythmias frequently reflect the high incidence of cardiac disease in stroke patients, in some cases they are secondary to the acute cerebrovascular lesion itself.