Electrocardiographic abnormalities and cardiac arrhythmias in structural brain lesions

Aristeidis H. Katsanos, Panagiotis Korantzopoulos, Georgios Tsivgoulis, Athanassios P. Kyritsis, Maria Kosmidou, Sotirios Giannopoulos

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

Cardiac arrhythmias and electrocardiographic abnormalities are frequently observed after acute cerebrovascular events. The precise mechanism that leads to the development of these arrhythmias is still uncertain, though increasing evidence suggests that it is mainly due to autonomic nervous system dysregulation. In massive brain lesions sympathetic predominance and parasympathetic withdrawal during the first 72 h are associated with the occurrence of severe secondary complications in the first week. Right insular cortex lesions are also related with sympathetic overactivation and with a higher incidence of electrocardiographic abnormalities, mostly QT prolongation, in patients with ischemic stroke. Additionally, female sex and hypokalemia are independent risk factors for severe prolongation of the QT interval which subsequently results in malignant arrhythmias and poor outcome. The prognostic value of repolarization changes commonly seen after aneurysmal subarachnoid hemorrhage, such as ST segment, T wave, and U wave abnormalities, still remains controversial. In patients with traumatic brain injury both intracranial hypertension and cerebral hypoperfusion correlate with low heart rate variability and increased mortality. Given that there are no firm guidelines for the prevention or treatment of the arrhythmias that appear after cerebral incidents this review aims to highlight important issues on this topic. Selected patients with the aforementioned risk factors could benefit from electrocardiographic monitoring, reassessment of the medications that prolong QTc interval, and administration of antiadrenergic agents. Further research is required in order to validate these assumptions and to establish specific therapeutic strategies.

Original languageEnglish (US)
Pages (from-to)328-334
Number of pages7
JournalInternational Journal of Cardiology
Volume167
Issue number2
DOIs
StatePublished - Jul 31 2013
Externally publishedYes

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Cardiac Arrhythmias
Brain
Adrenergic Antagonists
Intracranial Hypertension
Hypokalemia
Autonomic Nervous System
Subarachnoid Hemorrhage
Cerebral Cortex
Heart Rate
Stroke
Guidelines
Mortality
Incidence
Therapeutics
Research

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Electrocardiographic abnormalities and cardiac arrhythmias in structural brain lesions. / Katsanos, Aristeidis H.; Korantzopoulos, Panagiotis; Tsivgoulis, Georgios; Kyritsis, Athanassios P.; Kosmidou, Maria; Giannopoulos, Sotirios.

In: International Journal of Cardiology, Vol. 167, No. 2, 31.07.2013, p. 328-334.

Research output: Contribution to journalReview article

Katsanos, Aristeidis H. ; Korantzopoulos, Panagiotis ; Tsivgoulis, Georgios ; Kyritsis, Athanassios P. ; Kosmidou, Maria ; Giannopoulos, Sotirios. / Electrocardiographic abnormalities and cardiac arrhythmias in structural brain lesions. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 2. pp. 328-334.
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