Stroke, Vol 25, 113-116, Copyright © 1994 by American Heart Association
SA Barron, Z Rogovski and J Hemli
BACKGROUND AND PURPOSE--Recently, supraventricular tachycardia has been
reported following right hemisphere stroke, suggesting a reduction in
parasympathetic cardiac innervation after stroke of the right hemisphere.
We performed power spectrum analysis of fluctuations in RR interval
duration in the electrocardiogram in an attempt to determine how ischemic
stroke influences autonomic cardiac innervation. METHODS-- Power spectrum
analysis of the variation in 256 consecutive electrocardiographic RR
intervals was performed using the fast-Fourier transformation. The area
under the spectral curve from 0 to 0.5 Hz and the area under the portion of
the curve produced by parasympathetically mediated respiratory variations
were determined in 20 patients with right-hemisphere and 20 patients with
left-hemisphere ischemic stroke confirmed by computerized tomography. Data
were compared with 40 age- and sex-matched healthy controls. RESULTS--Total
cardiac autonomic innervation was reduced after a stroke of either
hemisphere without regard to laterality. Cardiac parasympathetic
innervation was reduced after stroke of either hemisphere with a
significantly greater reduction after stroke on the right (P = 2.9 x
10(-5). CONCLUSIONS-- Power spectral analysis of heart rate variability can
detect autonomic consequences of stroke. The spectral data predict that, to
the degree that cardiac arrhythmia is produced by unbalanced cardiac
autonomic activity favoring the sympathetic system, such arrhythmias could
be seen after stroke of either hemisphere and would be more common after
cerebral infarction on the right. This is consistent with evidence from the
recent literature.
ARTICLES
Autonomic consequences of cerebral hemisphere infarction
Laboratory of Clinical Neurophysiology, Bruce Rappaport Faculty of Medicine, Technicon-Israel Institute of Technology, Haifa.
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