Risk of cardiac dysrhythmias in chronic spinal cord injury patients

Abstract

The incidence of cardiac dysrhythmias is characterized in a group of 47 chronic SCI patients (greater than 30 days post injury; range 35-3605 days) with SCI lesions ranging from C4 to L3 who were referred for evaluation of a potential cardiac dysrhythmia by 24 hour Holter monitoring. Patients were grouped according to level of injury as paraplegic (T1 and below), n = 22, or quadriple gic (C3-C8), n = 25. No evidence of life threatening dysrhythmias was noted in either group, and no differences were evidenced in the incidence of cardiac dysrhythmias between the groups. Premature ventricular contractions (PYCs) were noted in 4/25 quadripelgics, and in 1/22 paraplegics, and right bundle branch block (RBBB) was noted in 1/25 quadriplegics and 1/22 paraplegics. A two-year chart review follow up revealed that no clinically significant cardiac dysrhythmic events occurred in these patients. These findings suggest that the risk of cardiac dysrhythmia is attenuated following the acute phases of SCI and represents a diminished concern to the clinician.

The relationship between neurological level of injury and symptomatic cardiovascular disease risk in the aging spinal injured

“…A propensity toward dysrhythmias has been documented acutely after SCI, 24 though it has not been shown that chronic SCI is associated with dysrhythmia in the absence of underlying CHD. 25 While dysrhythmia could be associated with heightened cerebrovascular disease risk, the reason why valvular disease is elevated according to level and Frankel/ASIA grade is unclear.…”

Cardiovascular Responses to Vibrostimulation for Sperm Retrieval in Men With Spinal Cord Injury

“…It is known from previous studies that at rest, individuals with SCI have a higher incidence of nonspecific ST elevation (and thus early repolarization) than do ablebodied individuals (6,7), and they are also reported to be at increased risk of developing ECG abnormalities, such as premature atrial contractions, intraventricular conduction delays, and bundle-branch blocks (2,3). Several studies have indicated that the incidence of arrhythmia in patients with SCI (particularly bradyarrhythmias) is increased and that those with higher lesions are more at risk of developing bradyarrhythmias (9).…”

“…However, the reasons for this are uncertain. It may be that SCI increases the risk of unstable blood pressure and cardiac arrhythmias (2)(3)(4)(5) or other electrocardiographic (ECG) abnormalities (6,7) that may predispose patients to adverse cardiac events. Most previous studies examining the incidence of cardiac arrhythmias in SCI patients have been performed while the subject was in the resting state (2,8,9).…”

Electrocardiographic abnormalities in the early stage following traumatic spinal cord injury

“…4 In addition to hemodynamic abnormalities, SCI can lead to cardiac arrhythmia including sinus bradycardia, supraventricular arrhythmia, ventricular arrhythmia and cardiac arrest. [5][6][7][8] Although these cardiac arrhythmias are relatively well recognized in the subacute and chronic stages after SCI, there is a paucity of studies focused on abnormal cardiac electrical activity during the early stages following SCI.…”