Spontaneous subarachnoid hemorrhage was associated with a 91% incidence of cardiac arrhythmias in the acute phase, with 41% of patients experiencing serious arrhythmias.
Observational (n=70)
Cardiac arrhythmias are extremely common and often serious in the acute phase of subarachnoid hemorrhage, warranting systematic continuous ECG monitoring.
The frequency and severity of cardiac arrhythmias were studied in 70 patients with spontaneous subarachnoid hemorrhage investigated prospectively with 24-hour Holter monitoring. Patients were less than 70 years old and without clinical and/or ECG signs of previous heart disease; Holter monitoring was initiated within 48 hours of subarachnoid hemorrhage. Arrhythmias were detected in 64 of the 70 patients (91%). Twenty-nine of the 70 patients (41%) showed serious cardiac arrhythmias; malignant ventricular arrhythmias, i.e., torsade de pointe and ventricular flutter or fibrillation, occurred in 3 cases. Serious ventricular arrhythmias were associated with QTc prolongation and hypokalemia. No correlation was found between the frequency and severity of cardiac arrhythmias and the neurologic condition, the site and extent of intracranial blood on computed tomography scan, or the location of ruptured malformation. The extremely high incidence of cardiac arrhythmias, sometimes serious, in the acute period after subarachnoid hemorrhage and the absence of clinical and radiologic predictors make systematic continuous ECG monitoring compulsory to improve the overall results of subarachnoid hemorrhage, irrespective of early or delayed surgical treatment.
Andreoli et al. (1987) conducted an observational in spontaneous subarachnoid hemorrhage (n=70). Spontaneous subarachnoid hemorrhage was evaluated on Frequency of cardiac arrhythmias. Spontaneous subarachnoid hemorrhage was associated with a 91% incidence of cardiac arrhythmias in the acute phase, with 41% of patients experiencing serious arrhythmias.