Date of Award
2020
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Dr. Philip Adebayo
Second Supervisor/Advisor
Dr. Ahmed Jusabani
Third Supervisor/Advisor
Dr. Robert S. Mvungi
Department
Internal Medicine (East Africa)
Abstract
Introduction: Cardiac arrhythmias are common and can be fatal in acute strokes, but they are often under-recognized. The presence of cardiac arrhythmia in acute stroke doubles the mortality.
Objectives: This study aimed to determine the types of cardiac arrhythmia in acute stroke patients admitted in two urban hospitals in Dar es Salaam, The Aga Khan Hospital, Dar es Salaam and Muhimbili National Hospital. The secondary objectives were to determine the associations between the characteristic of stroke and cardiac arrhythmias as well as to determine the impact of cardiac arrhythmia on 30- days stroke outcomes.
Methods: This was a prospective longitudinal study that recruited a total of 222 stroke patients admitted to the above-named hospitals from October 1, 2019, to March 30, 2020. The radiologically confirmed stroke patients were screened for cardiac arrhythmia using 12 lead Electrocardiograms within 72 hours post-stroke. The outcome measure was determined using the Modified Rankin Score on admission and day 30 of stroke.
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 the identified in acute stroke. Cardiac arrhythmias were independently associated with high stroke severity score, hemorrhagic stroke, and cerebral hemisphere stroke. Cardiac arrhythmia is an independent predictor of poor outcome in acute stroke. The study found that 62.5% of acute stroke patients with cardiac arrhythmia had 30 days of poor outcome with 27 % mortality.
Conclusion: Cardiac arrhythmia is very common in acute stroke. Serious arrhythmia in acute strokes such as Ventricular fibrillation and ventricular tachycardia are also common and can lead to sudden death. Understanding of the attributable types of cardiac arrhythmias in acute stroke patients has important implications for stroke management and prevention of mortality.
Recommended Citation
Msukuya, J. S. (2020). Profile of cardiac arrhythmia in acute stroke patients (Unpublished master's dissertation). Aga Khan University, East Africa.