Stroke, Vol 23, 362-366, Copyright © 1992 by American Heart Association
RD Lane, JD Wallace, PP Petrosky, GE Schwartz and AH Gradman
BACKGROUND AND PURPOSE: The physiological basis for the arrhythmias
commonly observed after a stroke is not well understood. Based on evidence
that the right and left cerebral hemispheres influence cardiac function in
different ways, we sought to determine whether the nature and severity of
cardiac arrhythmias in the context of an acute stroke vary in relation to
whether the stroke is located in the left or the right hemisphere. METHODS:
Data were obtained from the medical records of nineteen patients with left
hemisphere strokes and nineteen patients with right hemisphere strokes who
had also had 24-hour electrocardiographic (Holter) recordings within 2
weeks of admission to a stroke unit. Written Holter monitor reports already
on file were used for the data analysis. RESULTS: All four patients with
supraventricular tachycardia had right hemisphere strokes (p = 0.05). There
was a nonsignificant trend for left hemisphere stroke patients to have more
severe ventricular arrhythmias. CONCLUSIONS: These data provide partial
support for the hypothesis that the two cerebral hemispheres have a
differential influence on the nature and severity of arrhythmias following
an acute stroke. We speculate that parasympathetic tone was diminished
ipsilateral to the affected hemisphere associated with a reciprocal rise in
sympathetic tone on that side and recommend that a prospective study be
undertaken to test this hypothesis more definitively.
ARTICLES
Supraventricular tachycardia in patients with right hemisphere strokes
Department of Psychiatry, School of Medicine, University of Arizona, Tucson.
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