[Diseases of the central nervous system and cardiac arrhythmias].

Diseases of the central nervous system can result in various cardiac arrhythmias. In some neuromuscular disorders, a distinctive morphologic correlate of such arrhythmias can be found as a secondary cardiomyopathy. In other intracranial diseases, in particular subarachnoid and intracerebral hemorrhages, the lack of gross alterations of cardiac morphology suggests some "functional" nature of rhythm disturbances. Lesions of the autonomic regulatory centres frequently cause (unilateral) autonomic imbalance that is projected to the heart according to its asymmetric peripheral sympathetic innervation. The resultant propensity for sympathetically mediated arrhythmias is frequently reflected in prolongation of the QT interval and can be accentuated by simultaneous vagal discharge as well as catecholamine-mediated disseminated myocardial necroses. It is, however, unlikely that such neurogenic arrhythmias bear any independent prognostic significance; on the contrary, prognosis is usually determined by the severity of the underlying neurologic disease and its complications.