Electrocardiographic repolarization changes after neurologic conditions may presage cerebrogenic arrhythmias, which are likely mediated by the sympathetic nervous system and the insula.
This review highlights the pathophysiological link between cerebral events (like hemorrhage or epilepsy) and cardiac arrhythmias, emphasizing the role of the sympathetic nervous system and the insula.
Electrocardiographic repolarization changes, comprising QT prolongation, T-wave flattening or inversion, and ST-segment alterations, are most commonly seen after subarachnoid and intracerebral hemorrhage, but may occur in other neurologic conditions. They may presage arrhythmias. The effects likely are mediated by the sympathetic nervous system. Cerebral arrhythmogenesis may underlie sudden death in both normal and epileptic populations. Experimental evidence suggests that the insula has a cardiac chronotropic organization, and may be involved in the genesis of arrhythmias seen in epilepsy or after cerebral hemorrhage or stroke.
Stephen M. Oppenheimer (1990) conducted a review in Cerebrogenic Cardiac Arrhythmias. Electrocardiographic repolarization changes after neurologic conditions may presage cerebrogenic arrhythmias, which are likely mediated by the sympathetic nervous system and the insula.