Tripura Medical College and B .R. Ambedkar Memorial Teaching Hospital, Agartala.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Studies have reported that acute stroke leads to imbalance of central autonomic control; stroke can cause over activity of sympathetic or parasympathetic control, myocardial injury, ECG abnormalities, cardiac arrhythmias and even sudden death. Studies support the notion that patients with acute cerebrovascular events are susceptible to cardiac arrhythmias.
This cross Sectional Study was conducted in over a period of One and half year duration and included subjects of acute ischemic stroke confirmed by brain imaging. After performing a 12 lead ECG in emergency ward, all eligible stroke patients were subjected to 24 hour Holter monitoring.
Out of 92 stroke patients, 35.28% had abnormal ECG. Changes included LVH in 10.87%, T wave inversion in 9.78%, ST segment depression in4.35%% followed by QTc prolongation 3.26% .24 hours Holter monitoring revealed that common cardiac rhythm disturbances were ventricular ectopics (44.57%) supraventricular ectopics (30.43%), supraventricular tachycardia (11.96%), atrial fibrillation (7.60%). Amongst brady-arrhythmias sinus pause was detected in 1.09%.
ECG changes occur commonly in case of acute ischemic stroke, even in those having no history of coronary heart disease as suggested clinically. Identification of paroxysmal Atrial Fibrilation episodes is important due to its relevance for planning of long-term treatment.
摘要：研究表明急性脑卒中会导致中枢自主控制失衡；脑卒中可引起交感或副交感控制过度活跃、心肌损伤、心电图异常、心律失常，甚至猝死。研究支持急性脑血管事件患者易发生心律失常的观点。
材料：本横断面研究历时一年半，纳入经脑影像学证实的急性缺血性脑卒中患者。在急诊室进行 12 导联心电图检查后，所有符合条件的脑卒中患者均接受 24 小时动态心电图监测。
观察：92 例脑卒中患者中，35.28%心电图异常。改变包括左室肥厚 10.87%、T 波倒置 9.78%、ST 段压低 4.35%，随后是 QTc 延长 3.26%。24 小时动态心电图监测显示常见的心律失常为室性期前收缩（44.57%）、室上性期前收缩（30.43%）、室上性心动过速（11.96%）、心房颤动（7.60%）。缓慢性心律失常中检测到窦性停搏 1.09%。
结论：即使在临床上无冠心病史的情况下，急性缺血性脑卒中患者也常发生心电图改变。识别阵发性心房颤动发作很重要，因为这与长期治疗计划有关。
