Prevalence of Cardiac Arrhythmias in a Sample of Egyptian patients with Acute Ischemic Stroke

BackgroundStroke remains a leading global cause of death, with ischemic stroke representing the predominant subtype. Cardiac arrhythmias commonly accompany neurological disorders and often manifest as ECG changes. Among these, atrial fibrillation (AF) is especially important due to its strong association with ischemic stroke. This study evaluated the prevalence of arrhythmias in acute ischemic stroke and explored relevant risk factors.Patients and MethodsA cross-sectional study was conducted on 115 acute ischemic stroke patients recruited over six months from three tertiary hospitals. All participants underwent clinical assessment, laboratory investigations, brain imaging, ECG, echocardiography, carotid duplex, and, when indicated, Holter monitoring for extended rhythm evaluation.ResultsThe majority of patients presented with thrombotic stroke, mainly affecting the temporoparietal region and basal ganglia, with variable infarct sizes. Most received medical management, and wake-up strokes were frequent. About half required prolonged hospitalization. Routine ECG identified a limited number of arrhythmias, predominantly AF, whereas Holter monitoring detected significantly more cases and revealed additional rhythm abnormalities. MRI findings correlated positively with ASPECTS scores, AF was more frequent with increasing age, and more extensive MRI abnormalities were associated with fewer arrhythmias captured on Holter.ConclusionAF emerged as the most common arrhythmia in acute ischemic stroke. MRI findings and ASPECTS scoring contributed meaningfully to assessing severity, and extended cardiac monitoring enhanced arrhythmia detection, underscoring its value in stroke evaluation.