title: Serious cardiac arrhythmias after stroke: incidence, time course, and predictors--a systematic, prospective analysis.
abstract: OBJECTIVE
  Patients with acute cerebrovascular events are susceptible to serious cardiac arrhythmias, but data on the time course and the determinants of their onset are scarce.
  
  
  METHODS
  The prospective Stroke-Arrhythmia-Monitoring-Database (SAMBA) assessed cardiac arrhythmias with need for urgent evaluation and treatment in 501 acute neurovascular patients during the first 72 hours after admission to a monitored stroke unit. Arrhythmias were systematically detected by structured processing of telemetric data. Time of arrhythmia onset and predisposing factors were investigated.
  
  
  RESULTS
  Significant cardiac arrhythmias occurred in 25.1% of all patients. Incidence was highest during the first 24 hours after admission. Serious arrhythmic tachycardia (ventricular or supraventricular>130 beats/min) was more frequent than bradycardic arrhythmia (sinus-node dysfunction, bradyarrhythmia, or atrioventricular block °II and °III). Arrhythmias were independently associated with higher age and severer neurological deficits as measured by the National Institutes of Health Stroke Scale on admission.
  
  
  CONCLUSIONS
  The risk for significant cardiac arrhythmia after an acute cerebrovascular event is highest during the first 24 hours of care and declines with time during the first 3 days. Along with established vascular risk factors, the National Institutes of Health Stroke Scale may be considered for a stratified allocation of monitoring capabilities.
  
  
  BACKGROUND
  URL: www.clinicaltrials.gov. Unique identifier: NCT01177748.
authors.affiliation: Department of Neurology, University Medical Center Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Kallmünzer
authors.forename: Lorenz
authors.initials: L
authors.lastname: Breuer
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kahl
authors.forename: Tobias
authors.initials: T
authors.lastname: Bobinger
authors.forename: Dorette
authors.initials: D
authors.lastname: Raaz-Schrauder
authors.forename: Hagen Bernhard
authors.initials: HB
authors.lastname: Huttner
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
authors.forename: Martin
authors.initials: M
authors.lastname: Köhrmann
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000150:complications*; D013997:Time Factors