Seemant Chaturvedi, MD reviewing Bobinger T et al. Neurology 2017 May 16.

Prehospital electrocardiogram data are useful in triage and treatment decisions for stroke patients.

Atrial fibrillation (AF) is the leading cause of cardioembolic stroke and is paroxysmal in a substantial proportion of patients. In addition to AF, stroke patients could have other relevant cardiac problems, including acute myocardial ischemia and ventricular arrhythmias. To assess the value of prehospital electrocardiogram (ECG) recordings in stroke patients, investigators analyzed prehospital ECG recordings from 259 stroke patients (24% of all stroke patients admitted at 1 hospital; mean age, 76; 90% ischemic stroke, 10% intracerebral hemorrhage). AF was previously known in 73 of the patients (28%). New AF was identified in 31 patients (17%). The prehospital ECG showed AF in 18 patients, 2 of whom had AF documented only by the prehospital ECG.

In addition to AF, a paced rhythm was present in 5% of patients and second- or third-degree heart block in a similar percentage, 10% of patients had significant ventricular ectopy, and 5% of patients had ST-segment elevation.

CITATION(S):

Bobinger T et al. Diagnostic value of prehospital ECG in acute stroke patients. Neurology 2017 May 16; 88:1894.

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