Cerebrally induced cardiac arrhythmias (CICA)

Cerebrally induced cardiac arrhythmias pose a challenge in the care of the intensive care patient. Although prognosis is based mainly on the neurologic status, treatment of the arrhythmia should be instituted promptly especially where cardiac function is impaired. Correct diagnosis is of prime importance because delay of surgical intervention or inadequate choice of anticoagulants or antiarrhythmic drugs may be deleterious. Although descriptions of this phenomenon have appeared in the literature for decades, with the increasing capability of better and more successful management and the recognition of the significance of these on cardiac function, new attention should be focused on the subject. A review of the literature, diagnosis, and management of cerebrally induced cardiac arrhythmias is presented. Examples are given of patients without antecedent heart disease in whom cardiac arrhythmias secondary to neurologic compromise later manifested.