Detection and Significance of Nonsustained Ventricular Tachycardia in a Post-Stroke Population.

Background: Clinical guidelines recommend cardiac rhythm monitoring in post-stroke patients.

Objectives: This study sought to assess the prevalence and significance of nonsustained ventricular tachycardia (NSVT) in patients who have had an ischemic stroke or transient ischemic attack (TIA).

Methods: The CAMPS (Cardiac Ambulatory Monitoring Post Stroke) study was composed of post-stroke or TIA patients who were referred for ambulatory cardiac rhythm monitoring. Between 2019 and 2023, 752 patients completed cardiac monitoring within 1 year of the ischemic event. We evaluated the association between the presence of NSVT and the risk of subsequent stroke, cardiac events, or death.

Results: Patients were monitored for a mean of 19 ± 7 days, and NSVT was observed in 164 patients (22%). Compared with patients who did not have NSVT, those with NSVT were older, more likely to be male, smoke, and have a higher prevalence of coronary heart disease. Patients with NSVT had a higher risk of subsequent stroke (HR: 2.65; 95% CI: [1.74-4.02]), cardiac events (HR: 2.25; 95% CI: [1.40-3.64]), and death (HR: 1.87; 95% CI: [1.12-3.15]). These estimates remained significant after adjustment for demographics and clinical factors: subsequent stroke (HR: 2.50; 95% CI: [1.59-3.93]), cardiac events (HR: 1.86; 95% CI: [1.11-3.11]), and death (HR: 1.90; 95% CI: [1.09-3.31]). In this exploratory analysis, a higher NSVT burden was associated with increased risk of adverse events.

Conclusions: NSVT in patients with recent stroke or TIA is independently associated with a 2- to 3-fold increased risk of subsequent stroke, cardiac events, and death after controlling for demographics and clinical factors.