%0 Journal Article
%T Heart rate monitoring on the stroke unit. What does heart beat tell about prognosis? An observational study
%A Martin A Ritter
%A Anne Rohde
%A Peter U Heuschmann
%A Rainer Dziewas
%A J£¿rg Stypmann
%A Darius G Nabavi
%A Bernd E Ringelstein
%J BMC Neurology
%D 2011
%I BioMed Central
%R 10.1186/1471-2377-11-47
%X Demographical data, stroke risk factors, NIH stroke scale score, lesion size and location, and ECG parameters were prospectively assessed in 256 patients with ischemic stroke. Patients were continuously monitored for at least 24 hours on a certified stroke unit. Tachycardia (HR ¡Ý120 bpm) and bradycardia (HR <45 bpm) and cardiac rhythm (sinus rhythm or atrial fibrillation) were documented. We investigated the influence of risk factors on HR disturbances and their respective influence on dependence (modified Rankin Scale ¡Ý 3 after three months) and mortality.HR ¡Ý120 bpm occurred in 39 patients (15%). Stroke severity (larger lesion size/higher NIHSS-score on admission), atrial fibrillation and HR on admission predicted its occurrence. HR <45 bpm occurred in 12 patients (5%) and was predicted by lower HR on admission. Neither HR ¡Ý120 nor HR <45 bpm independently predicted poor outcome at three moths. Stroke location had no effect on the occurrence of HR violations. Clinical severity and age remained the only consistent predictors of poor outcome.Significant tachycardia and bradycardia are frequent phenomena in acute stroke; however they do not independently predict clinical course or outcome. Continuous monitoring allows detecting rhythm disturbances in stroke patients and allows deciding whether urgent medical treatment is necessary.Cardiac complications are frequent after acute stroke and, vice versa, cardiac disease is a frequent cause of stroke. About 30% of all strokes are classified as cardioembolic with atrial fibrillation (AF) being the single most important risk factor [1]. The prominent cardiac complications are known since a long time and include myocardial infarctions (MI), tachycardia, and bradycardia [2]. Heart rate (HR) monitoring and maintenance of a normal HR is an essential part of stroke unit treatment [3,4]. However, in contrast to blood pressure, no definition of what is a normal HR is given, and questions arise from this recommendation: What to do
%U http://www.biomedcentral.com/1471-2377/11/47