Systemic Embolism in Chronic Sinoatrial Disorder

Fairfax, A J; Lambert, Colin D.; Leatham, Aubrey

doi:10.1056/nejm197607222950403

Cited by 154 publications

(33 citation statements)

References 20 publications

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“…Such a mechanism is easier to demonstrate in patients with reversible transient focal episodes than in those where the stroke is complete and irreversible. Five of these patients had sick sinus syndrome and since previous studies 16 ' 16 have attributed a major role to systemic embolism in patients with this syndrome, an embolic etiology cannot be excluded.…”

Section: Discussionmentioning

confidence: 93%

Cardiac arrhythmias in acute stroke.

Norris¹,

Froggatt²,

Hachinski³

1978

Stroke

129

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SUMMARY Cardiac arrhythmias were more frequent (P < 0.001) in 312 stroke patients admitted to an intensive care stroke unit, than in 92 patients admitted to the unit and subsequently found not to have strokes. This significant difference remained when a stroke subgroup and the non-stroke group were matched for age, sex and duration of stay in the unit (P < 0.005). Hypertension and hypertensive cardiac disease were more common in the stroke than in the non-stroke patients (P< 0.001).Ectopic beats and atrial fibrillation, as well as other arrhythmias, were most frequent in patients with cerebral hemisphere infarction, and patients with hemispheric lesions had significantly more arrhythmias than those with brain stem lesions (P < 0.05).These arrhythmias were rarely (2%) responsible for hemodynamic ischemic cerebrovascular lesions, but may have been associated with cerebral embolism in up to 17% of cases. The cardiac arrhythmias appeared to have little influence on the course of the subsequent recovery from stroke. Although these arrhythmias frequently reflect the high incidence of cardiac disease in stroke patients, in some cases they are secondary to the acute cerebrovascular lesion itself.

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Section: Discussionmentioning

confidence: 93%

Cardiac arrhythmias in acute stroke.

Norris¹,

Froggatt²,

Hachinski³

1978

Stroke

129

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“…Fairfax et al studied 100 patients with chronic sino-atrial disorders and found 16 examples of embolism which included 19 cerebral events and 7 systemic events. 31 Because the brain is divided into a myriad of uniquely functioning areas, sudden interruption of its blood supply is likely to disrupt function at least temporarily. In systemic vessels, limb emboli, if small, might cause a cramp or temporary coldness of the limb; renal, splenic, or other visceral emboli might cause transient abdominal or flank pain or diarrhea, symptoms usually not considered as important clues to serious disease.…”

Section: Discussionmentioning

confidence: 99%

Cerebral embolism in the Michael Reese Stroke Registry.

Caplan¹,

Hier²,

D’Cruz³

1983

Stroke

228

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“…- 6 In a long-term follow-up study of 254 patients with episodic sick sinus syndrome, however, the annual risk of a cerebral embolic event was 9.7 per cent for patients with the bradytachy syndrome and 5.3 per cent for patients with bradyarrhythmias alone. 9 The risk appeared not to be related to the severity of the bradycardia.…”

mentioning

confidence: 98%

Holter monitoring in patients with transient and focal ischemic attacks of the brain.

Koudstaal¹,

Gijn²,

Klootwijk³

et al. 1986

Stroke

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SUMMARYThe results of Holter monitoring in 100 patients with transient and focal cerebral ischemia were studied retrospectively. Atrial fibrillation (AF) was found in five patients compared with two from a group of 100 age and sex-matched control patients. Four of these had a previous history of AF or showed AF on the standard electrocardiogram. Episodic forms of sick sinus syndrome, which have also been related to cerebral embolism, were found in 32 of the TIA patients against 13 of the controls (p < 0.0025). Sick sinus syndrome was of the bradyarrhythmia-tachyarrhythmia type in 14 of the TIA patients and in three of the controls (p < 0.01). The relationship between TIAs and transient sinus node dysfunction could not be explained by concomitant heart disease. It is not yet clear whether the relationship is causal or indirect.

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Systemic Embolism in Chronic Sinoatrial Disorder

Cited by 154 publications

References 20 publications

Cardiac arrhythmias in acute stroke.

Cardiac arrhythmias in acute stroke.

Cerebral embolism in the Michael Reese Stroke Registry.

Holter monitoring in patients with transient and focal ischemic attacks of the brain.

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