Spectrum of cardiac arrythmias and its influence on 30-day stroke mortality in Dar es Salaam

Document Type

Article

Department

Internal Medicine (East Africa)

Abstract

Background and aims

Cardiac arrythmias are common after stroke due to the disruption of the brain-heart autonomic regulation. Our aim was to profile the types of cardiac arrythmias in acute stroke patients admitted to the Muhimbili National Hospital (MNH) and the Aga Khan Hospital (AKH), Dar es Salaam. We determined the clinical correlates of cardiac arrythmia and the effect of cardiac arrythmias on 30 days stroke mortality among the cohort.

Methods

This was a prospective longitudinal observational study of consecutive stroke patients, 18-years and above admitted to the above hospitals between October 2019 and March, 2020. Radiologically confirmed stroke patients were screened for cardiac arrhythmia using 12-lead ECG within 72 hours post stroke. 30 days case fatality was determined.

Results

Among 222 acute stroke patients admitted, significant cardiac arrhythmia occurred in 30 patients (13.96 %) in the first 72 hours of acute stroke. Atrial fibrillation 10(5.4 %), ventricular tachycardia 7(3.2 %), sinus arrhythmia 7(3.2 %), sinus bradyarrhythmia 2(0.9 %), ventricular fibrillation 2(0.9 %), premature ventricular complex 2(0.9 %) and atrial flutter 1(0.5 %) were identified in acute stroke. Cardiac arrhythmias were independently associated with high stroke severity score, haemorrhagic stroke and left cerebral hemisphere stroke. Cardiac arrhythmia was an independent predictor of poor outcome in acute stroke. 30-days case fatality was 27% among the cohort with cardiac arrythmias.

Conclusions Cardiac arrhythmia are common in this cohort of acute stroke patients. Atrial fibrillation and ventricular tachycardia were the leading arrythmias. Presence of cardiac arrythmias contributes to poor stroke outcome.

Publication (Name of Journal)

Journal of the Neurological Sciences

DOI

10.1016/j.jns.2023.122388

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