Transient Cerebral Ischemia Due to Arrhythmia

Abstract

The diagnostic value of a continuous 10-hr tape-recorded electrocardiogram was evaluated in 39 ambulatory patients with symptoms of cerebral ischemia. Twenty-eight had symptoms of diffuse cerebrovascular insufficiency (dizziness, giddiness or syncope); 11 had classic transient cerebral ischemic attacks. No patient had a prior significant arrhythmia or conduction abnormality diagnosed clinically or by standard electrocardiogram. Patients with bradycardia below 40/min, tachycardia over 150/min, or high-grade atrioventricular (AV) block were considered to have arrhythmias capable of producing their symptoms. Ten of the 39 patients had one of the above arrhythmias; in seven of these the arrhythmias correlated with symptoms. Eight of the 10 "positives" occurred in patients with diffuse cerebrovascular insufficiency; 7 of these had supraventricular tachycardia, and 1 had sinus bradycardia. Specific antiarrhythmic therapy gave an excellent result in five patients and fair improvement in three.