Telemetry Reveals Stroke Patients' Cardiac Problems

To detect "silent” or new cardiac abnormalities, all patients hospitalized for stroke should be under continuous cardiac rhythm monitoring (telemetry) for at least the first 24 hours after the stroke is detected, according to a new study.

Researchers at Loyola University (Chicago,IL, USA) reviewed records of 337 stroke patients, 289 of them placed on telemetry. Among the telemetry patients, 80% had normal rhythms, but the remainder had abnormal rhythms. Results of the study showed that 17% of the patients placed on telemetry developed new cardiac rhythms while monitored. New-onset atrial fibrillation was detected in 22 (7.6%) of all patients monitored on telemetry.

Cardiovascular risk factors were discovered more frequently in the patients placed on telemetry as compared to those who were not monitored. In addition, patients whose cardiac rhythms changed following admission had a higher percentage of coronary artery disease than those whose rhythms remained static. All patients found to have a new rhythm following telemetry monitoring had no previous history of arrhythmia. The authors therefore suggest that upon admission to the hospital, all patients should be monitored. The findings were presented at the American Stroke Association's international conference, held in February 2006 in Kissimmee (Florida, USA).

"Many patients have paroxysmal or otherwise ‘silent' arrhythmias, which may not show up until after a stroke occurs, said study co-author Dr. Michael J. Schneck, director of the neuro-intensive care program at Loyola University's health system. "Continuous cardiac rhythm monitoring allows for the discovery of unsuspected paroxysmal abnormalities, such as atrial fibrillation, which may be important in determination of antithrombotic therapy post stroke. It is well-known that there is a strong association between this rhythm and ischemic cardioembolic stroke. It also is important to identify these dysrhythmias as early as possible in order to prevent the progression of infarct size with subsequent worsening neurologic deficits.”



Related Links:
Loyola University Chicago