Evaluation of arrhythmia frequency by holter electrocardiography in patients with acute ischemic cerebrovascular events

Abstract

Aim: After acute ischemic cerebrovascular accident (CVA), identification of high-risk patients, appropriate cardiac follow-up and detection of arrhythmias are important to prevent cardiac morbidity and mortality. The aim of our study is to determine the underlying etiology and the frequency of arrhythmia by holter electrocardiography (ECG) in patients referred to the cardiology clinic due to acute ischemic CVA. Materials and Methods: A total of 135 consecutive patients who had acute ischemic CVA between January 2019 and June 2021 and whose basal ECG was sinus rhythm were included in the study. This study was a retrospective cross-sectional study. Results: The mean age of the patients was 72.02±11.02 years, the mean systolic arterial blood pressure was 138.84±20.45 mmHg, and the mean heart rate was 81.63±16.18 beats/min. The most common comorbid diseases were HT (n=67, %49.6) and CAD (n=55, %40.7). 5.9% of patients had prosthetic heart valve and 5.2% had permanent pacemaker. Intracardiac thrombus was detected in 5 (3.7%) patients. The mean left ventricular ejection fraction was 54.4±9.1%. In carotid doppler ultrasonography (USG), 27 (20%) patients had unilateral and 17 (12.6%) bilateral severe carotid arterial stenosis. The most common arrhythmias detected on holter ECG were ventricular extrasystole (n=34, 25.2%) and paroxysmal atrial fibrillation (n=31, 23%). In addition, non-sustained ventricular tachycardia was detected in 6 (4.4%) patients. Conclusion: Determining the underlying etiology in patients with acute ischemic CVA is important for the treatment of the disease. The incidence of arrhythmia that should be treated in this patient group is too high to be ignored.