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| Routine telemetry urged to identify new arrhythmias after stroke |
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21 February 2006
US researchers recommend routine use of continuous cardiac rhythm telemetry during acute stroke care, on finding that a substantial proportion of patients develop new cardiac abnormalities.
"Approximately 30% of patients with atrial fibrillation and flutter do not know they have an irregular heartbeat," said Dr Michael Schneck, the lead researcher of the study. "Therefore, patients without a known arrhythmia, who are not placed on telemetry units, may have an underlying rhythm that predisposes them to stroke or future cardiac dysfunction."
The team, from Loyola University in Maywood, Illinois, reviewed the hospital records of 337 stroke patients, of whom 289 were placed on telemetry for at least 24 hours. Normal cardiac rhythm was initially seen in 80% of these patients, with the remainder having abnormalities including atrial fibrillation, junctional rhythms, and runs of ventricular tachycardia. Notably, 17% of patients who initially had sinus rhythm subsequently developed an arrhythmia, about half of which were new onset atrial fibrillation or flutter.
Presenting their results at the 2006 American Stroke Association International Stroke Conference in Kissimmee, Florida, the researchers suggested that these cardiac dysrhythmias may have resulted from the effects on the body that can follow a stroke. "This finding is significant in that the new rhythm may have both immediate and long-term neurologic and cardiac implications," they said. Nine of the 22 patients who developed new onset atrial fibrillation were prescribed warfarin. "Monitoring rhythms is of prognostic significance for patients in the years of life that follow and may help to determine appropriate secondary preventive interventions," Dr Schneck concluded.
Reference:
American Stroke Association International Stroke Conference: Kissimmee, Florida, USA; 16-18 February 2006
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