Pattern of Arrhythmia among Ischemic Stroke Patients on 24-hour Ambulatory Electrocardiography (Holter ECG) in South-South Nigeria

Abstract

Background: The 24-hour Holter electrocardiogram is a valuable tool for the identification of ischaemic alterations, cardiac arrhythmias in hypertension, stroke and other cardiovascular conditions. Electrocardiographic (ECG) abnormalities and cardiac arrhythmias have been detected in 50% of stroke patients. However, literature in this area of research is limited in our environment. This study is aimed at describing the pattern of arrhythmia observed in patients with ischaemic stroke using 24-hour Holter ECG in our locality. Methods: A total of 22 stroke subjects whose age ranged from 41 and 83 years were evaluated in GoodHeart Medical Consultants hospital for 24-hour ambulatory ECG (Holter ECG) from January 2015 – December 2016. The Holter ECG data was acquired using Schiller type (MT-101) Holter ECG machine. Results: The study population consisted of 59.1% females and 40.9% males, with an average age of 66.95±12.32 years. Arrhythmias were more prevalent among females compared to males. However, bradycardia was more prevalent in males. Ventricular ectopics were the most common type of arrhythmia across both genders, with a higher prevalence in the older adult age group of 61-80 years. Conclusion: The most common arrhythmia observed among the stroke subjects in Southern Nigeria is ventricular ectopics. This could be due to increase in age and severe neurological deficit which are independent predictors of arrhythmia onset and this was notably seen among the older subjects in the study. Extended cardiac monitoring such as Holter ECG is a well-accepted method for the identification of ECG abnormalities and the implementation of prompt treatment to reduce mortality.