title: Cardiac arrhythmias the first month after acute traumatic spinal cord injury.
abstract: OBJECTIVE
  Cardiovascular complications including cardiac arrest and arrhythmias remain a clinical challenge in the management of acute traumatic spinal cord injury (SCI). Still, there is a lack of knowledge regarding the characteristics of arrhythmias in patients with acute traumatic SCI. The aim of this prospective observational study was to investigate the occurrence of cardiac arrhythmias and cardiac arrests in patients with acute traumatic SCI.
  
  
  METHODS
  As early as possible after SCI 24-hour Holter monitoring was performed. Additional Holter recordings were performed 1, 2, 3, and 4 weeks after SCI. Furthermore, 12-lead electrocardiograms (ECGs) were obtained shortly after SCI and at 4 weeks.
  
  
  RESULTS
  Thirty patients were included. Bradycardia (heart rate (HR) <50 b.p.m.) was present in 17-35% of the patients with cervical (C1-C8) SCI (n = 24) within the first 14 days. In the following 14 days, the occurrence was 22-32%. Bradycardia in the thoracic (Th1-Th12) SCI group (n = 6) was present in 17-33% during the observation period. The differences between the two groups were not statistically significant. The mean minimum HR was significantly lower in the cervical group compared with the thoracic group both on 12-lead ECGs obtained shortly after SCI (P = 0.030) and at 4 weeks (P = 0.041).
  
  
  CONCLUSIONS
  Many patients with cervical SCI experience arrhythmias such as bradycardia, sinus node arrest, supraventricular tachycardia, and more rarely cardiac arrest the first month after SCI. Apart from sinus node arrests and limited bradycardia, no arrhythmias were seen in patients with thoracic SCI. Standard 12-lead ECGs will often miss the high prevalence these arrhythmias have.
authors.forename: Kim
authors.initials: K
authors.lastname: Bartholdy
authors.forename: Tor
authors.initials: T
authors.lastname: Biering-Sørensen
authors.forename: Lasse
authors.initials: L
authors.lastname: Malmqvist
authors.forename: Martin
authors.initials: M
authors.lastname: Ballegaard
authors.forename: Andrei
authors.initials: A
authors.lastname: Krassioukov
authors.forename: Birgitte
authors.initials: B
authors.lastname: Hansen
authors.forename: Jesper Hastrup
authors.initials: JH
authors.lastname: Svendsen
authors.forename: Anders
authors.initials: A
authors.lastname: Kruse
authors.forename: Karen-Lise
authors.initials: KL
authors.lastname: Welling
authors.forename: Fin
authors.initials: F
authors.lastname: Biering-Sørensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000175:diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*
keywords: Arrhythmias; Bradycardia; Cardiac arrest; Holter monitor; Spinal cord injury; Supraventricular tachycardia