Cardiac arrhythmias the first month after acute traumatic spinal cord injury

Kim Bartholdy; Tor Biering-Sørensen; Lasse Malmqvist; Martin Ballegaard; Andrei Krassioukov; Birgitte Hansen; Jesper Hastrup Svendsen; Anders Kruse; Karen-Lise Welling; Fin Biering-Sørensen

doi:10.1179/2045772313Y.0000000181

Cardiac arrhythmias the first month after acute traumatic spinal cord injury

Kim Bartholdy, Tor Biering-Sørensen, Lasse Malmqvist, Martin Ballegaard, Andrei Krassioukov, Birgitte Hansen, Jesper Hastrup Svendsen, Anders Kruse, Karen-Lise Welling, Fin Biering-Sørensen

Department of Clinical Medicine

17 Citations (Scopus)

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). Conclusion: 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.

Original language	English
Journal	Journal of Spinal Cord Medicine
Volume	37
Issue number	2
Pages (from-to)	162-170
Number of pages	9
ISSN	1079-0268
DOIs	https://doi.org/10.1179/2045772313Y.0000000181
Publication status	Published - Mar 2014

Keywords

Adult
Aged
Aged, 80 and over
Arrhythmias, Cardiac
Electrocardiography
Female
Humans
Male
Middle Aged
Prospective Studies
Spinal Cord Injuries

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10.1179/2045772313Y.0000000181

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@article{f2522aac8df24f509c5a0c0abe9bbda5,

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). Conclusion: 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.",

keywords = "Adult, Aged, Aged, 80 and over, Arrhythmias, Cardiac, Electrocardiography, Female, Humans, Male, Middle Aged, Prospective Studies, Spinal Cord Injuries",

author = "Kim Bartholdy and Tor Biering-S{\o}rensen and Lasse Malmqvist and Martin Ballegaard and Andrei Krassioukov and Birgitte Hansen and Svendsen, {Jesper Hastrup} and Anders Kruse and Karen-Lise Welling and Fin Biering-S{\o}rensen",

year = "2014",

month = mar,

doi = "10.1179/2045772313Y.0000000181",

language = "English",

volume = "37",

pages = "162--170",

journal = "Journal of Spinal Cord Medicine",

issn = "1079-0268",

publisher = "Taylor & Francis",

number = "2",

}

TY - JOUR

T1 - Cardiac arrhythmias the first month after acute traumatic spinal cord injury

AU - Bartholdy, Kim

AU - Biering-Sørensen, Tor

AU - Malmqvist, Lasse

AU - Ballegaard, Martin

AU - Krassioukov, Andrei

AU - Hansen, Birgitte

AU - Svendsen, Jesper Hastrup

AU - Kruse, Anders

AU - Welling, Karen-Lise

AU - Biering-Sørensen, Fin

PY - 2014/3

Y1 - 2014/3

N2 - 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). Conclusion: 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.

AB - 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). Conclusion: 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.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Arrhythmias, Cardiac

KW - Electrocardiography

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Spinal Cord Injuries

U2 - 10.1179/2045772313Y.0000000181

DO - 10.1179/2045772313Y.0000000181

M3 - Journal article

C2 - 24559419

SN - 1079-0268

VL - 37

SP - 162

EP - 170

JO - Journal of Spinal Cord Medicine

JF - Journal of Spinal Cord Medicine

IS - 2

ER -

Cardiac arrhythmias the first month after acute traumatic spinal cord injury

Abstract

Keywords

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