Electrocardiographic Changes in Patients With Brain Tumors

OBJECTIVE: Electrocardiographic (ECG) abnormalities in patients with cerebral tumors involving the limbic system without known organic heart disease. DESIGN: Retrospective survey. SETTING: A university hospital in Berlin, Germany. PATIENTS: From among 169 consecutive patients with brain tumors, 57 patients were excluded on the basis of preexisting cardiac or other diseases and 27 patients were excluded because neuroimaging revealed multiple lesions or suggestive evidence of raised intracranial pressure. MAIN OUTCOME MEASURES: We compared ECG changes in 85 otherwise healthy patients with limbic and extralimbic brain tumors without evidence of increased intracranial pressure. Tumors were localized by magnetic resonance imaging and, in 15 cases, by computed tomography. Categorization of patients into limbic and extralimbic system groups was specified before routine preoperative ECGs were examined and classified by an independent cardiologist. RESULTS: Electrocardiographic changes were found in 40% of all patients. Abnormal ECG results were associated nearly three times more often with tumors located in the limbic system compared with extralimbic locations (72% vs 27%). Prolonged QTc intervals were significantly more frequent in the limbic system group than in the extralimbic group (mean rates, 113.3% vs 103.6%). CONCLUSIONS: Lesions of limbic structures do exert cardioarrhythmogenic effects and may provide an explanation for ECG abnormalities in patients with cerebral tumors.