This study aimed to investigate electrocardiographic alterations in the acute phase of stroke, its presentation, and complications.

Stroke-heart consists of cardiac alterations or worsening of premorbid cardiac function after ischemic stroke. The prevalence of pathological changes at the electrical level is 70-90% in these patients, mainly regarding repolarization, rhythm disturbances, including AFDAS (atrial fibrillation detected after stroke), and atrioventricular conduction delays.

A cross-sectional study of 181 patients admitted to the emergency department for stroke who had electrocardiographic and neuroimaging monitoring with evidence of ischemic injury.

Of the 181 patients included in the study, 55.2% were male. Their average age was 68 years. Arterial hypertension was present in 87.8% of the patients. Electrocardiographic alterations were present in 50.3% of the patients, rhythm disorders were the most prevalent at 20.6% (atrial fibrillation and sinus tachycardia) and repolarization disorders at 19.4% (inverted T waves). The most common etiology was atherosclerosis (57.5%). The most affected vascular territories were the middle cerebral artery (74.4%), the left hemisphere (48.6%), and the temporoparietal lobes (28.9%). 40.6% of patients had moderate infarcts according to their score in NIHSS. On the modified Rankin Scale, 37.8% of the patients had a score of 4 corresponding to moderately severe disabilities. A significant association was found, in terms of mortality in patients who presented ventricular tachycardia (p = 0.04). The pathological antecedents with the most representative electrical disorders were previous arrhythmias and atrial fibrillation (p = 0.004), previous stroke and ST-segment elevation (p = 0.04) and obesity with atrial flutter (p = 0.003).

Electrocardiographic abnormalities following cerebral infarction were presented in half of the population. Rhythm disorders, especially new-onset atrial fibrillation, were the most common, followed by repolarization disorders, of which, in the bivariate analysis, ventricular tachycardia was significantly associated with mortality, as were arrhythmias prior to the onset of atrial fibrillation.