Electrocardiography Holter Monitoring Abnormalities in Acute Intracerebral Hemorrhages



Asadollahi M¹ ; Ramezani M¹ ; Sharif F¹ ; Karimialavijeh E² Show Affiliations
Source: Critical Care and Shock Published:2018

Abstract

Objective: To avoid the misinterpretation of electrocardiogram (ECG) abnormalities in acute intracerebral hemorrhage (ICH), it is important to recognize ECG abnormalities in such patients. Previous studies have reported ECG disorders in ICH patients based on a single ECG tracing. In this study, we used ECG Holter monitoring to determine ECG abnormalities in acute ICH patients. Methods: This was a prospective analysis of acute (up to 24 hours following admission) nontraumatic ICH patients who were admitted to our hospital between January 2014 and April 2015. Initially, an ECG and cerebral computed tomography (CT) scan were obtained within the first day of admission. The patients then underwent ECG Holter monitoring for 24 hours. Finally, the ECG abnormalities and their association with the CT scan findings were analyzed. Results: This study included 108 patients with acute non-traumatic ICH. The most frequent ECG abnormalities shown by Holter monitoring were ectopic beats (85.2%), followed by sinus tachycardia (63.2%). Only the presence of midline shift on the CT scan had a significant correlation with ectopic beats (OR: 1.3, CI: 1.05-1.7). Conclusion: ECG Holter monitoring in 108 acute ICH patients demonstrated a correlation between the presence of midline shift on the cranial CT scan and ectopic beats in the ECG Holter monitoring. © 2018, Indonesian Society of Critical Care Medicine. All rights reserved.