Cardiac Arrhythmias and Abnormal Electrocardiograms After Acute Stroke

Ruthirago, Doungporn; Julayanont, Parunyou; Tantrachoti, Pakpoom; Kim, Jong-Yeol; Nugent, Kenneth

doi:10.1016/j.amjms.2015.10.020

Cited by 37 publications

(29 citation statements)

References 41 publications

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“…The interval between the stroke onset and the consequence of ventricular arrhythmogenesis has not been clarified because the long-term studies with large sample sizes are lacking. According to the available studies, new VAs are mostly detected within 3 days after the stroke onset [16,17]. In the present study, although we failed to perform the postoperative continuous ECG monitoring, we found that the number of spontaneous VPB was markedly increased in the AS group during the 1 hour ECG monitoring.…”

Section: Figure 5: (A)contrasting

confidence: 42%

Left Stellate Ganglion Ablation Inhibits Ventricular Arrhythmias through Macrophage Regulation in Canines with Acute Ischemic Stroke

Wang¹,

He²,

Xiong³

et al. 2021

Int. J. Med. Sci.

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Section: Figure 5: (A)contrasting

confidence: 42%

Left Stellate Ganglion Ablation Inhibits Ventricular Arrhythmias through Macrophage Regulation in Canines with Acute Ischemic Stroke

Wang¹,

He²,

Xiong³

et al. 2021

Int. J. Med. Sci.

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“…Sementara untuk pemilihan anti-aritmia pada pasien dengan stroke, penggunaan beta blocker memiliki manfaat dengan mekanisme antagonis terhadap overaktifitas dari kontrol simpatis. Penatalaksanaan aritmia setelah stroke akut dirangkum sebagai berikut: 5,6 Gambar 8. Tinjauan Skematik Penatalaksanaan Aritmia Setelah Stroke Akut 6…”

Section: Diskusiunclassified

Ventrikular Takikardia Refrakter Pada STEMI & Stroke

Daindes

Rasyid²

2018

JKA

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AbstrakPasien STEMI memiliki resiko 4 kali lebih tinggi untuk mengalami aritmia ventrikel yang umumnya terjadi dalam 48 jam pertama setelah onset. Dengan kondisi penyakit penyerta berupa stroke dengan skor severitas berat atau stroke hemoragik, intervensi koroner perkutan (IKP) atau pemberian obat -obatan anti trombotik tidak dapat dilakukan pada fase -fase awal. Optimalisasi obat -obatan anti-iskemik dan anti-aritmia menjadi strategi utama. Aritmia sendiri cukup sering dijumpai selama fase akut stroke, namun mekanisme aritmia ventrikel pada sindroma koroner akut (SKA) dan fase akut stroke masih diperdebatkan. Terlalu absurd jika hanya memikirkan kelainan jantung sebagai penyebab aritmia, mengabaikan kejadian neurologis yang juga sedang terjadi. Beberapa penelitian menunjukkan STEMI & stroke akut dapat memicu timbulnya aritmia ventrikel melalui mekanisme yang berbeda. Laporan Kasus ini dibuat untuk memberikan contoh praktikal dari ilustrasi diatas. Pada kasus ini pasien memiliki 2 entitas penyakit akut disaat bersamaan, yakni STEMI dan stroke. Pasien juga mengalami aritmia ventrikular yang refrakter. Pada akhirnya, dapat ditarik kesimpulan bahwa aritmia yang timbul bukan hanya diakibatkan oleh kelainan kardiovaskular semata, yang lebih umum dipahami, tetapi juga sebagai komplikasi dari kelainan akut neurologis. Diperlukan penanganan multi-disiplin ilmu dan komperhensif untuk optimalisasi manajemen pasien ini. AbstractPatients with ST elevation myocardial infarction (STEMI) have a 4-fold higher risk for ventricular arrhythmia (VA), mostly occurred in first 48 hours. In concomitant condition with acute stroke especially those with high stroke scoring or haemorragic stroke, percutaneous coronary intervention (PCI) can not be performed early and anti thrombotic therapy can not be given. Optimal anti ischemic and anti arrhythmic therapy are the most important strategy in this case. Meanwhile, cardiac arrhythmias following acute stroke is not rare but mechanisms of VA in acute coronary syndrome (ACS) concomitan with acute phase of stroke still debated. It is unlikely to assume that underlying cardiac diseases are the only cause of arrhythmia and cardiac damage after an acute stroke, ignoring neurologic event itself. Studies showed both STEMI and acute stroke could lead to ventricular arrhythmia with different mechanism. Present case report was made as practical example of previous illustration. In this case, patient with 2 acute illneses at the same time, STEMI and stroke. Patient also suffered refractory ventricular arrhythmia. At the end, we can conclude that arrhythmia was not only caused by cardiovascular problem, as usual understandings, but also due to complication of acute neurologic event. Multi-discipline management was needed to optimalize patient's outcome.

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“…The patho-physiological mechanisms may be related to exaggerated stressinduced release of catecholamines with subsequent acute imbalance of autonomic control of the heart [1]. The autonomic imbalance may lead to hypercontraction of sarcomeres, cardiac stunning, coronary vasospasm, ECG and left ventricular wall motion abnormalities and lifethreatening arrhythmias [2]. The insular cortex plays an important role in the central autonomic network.…”

Section: Diagnosismentioning

confidence: 99%