Heart & lung : the journal of critical care · 2026
Anatomical and radiographic stroke topography predicts ventricular and atrial ectopic burden.
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Seth Jayant, Rabkin Simon W
Аннотация
BACKGROUND: Stroke-related dysregulation can trigger cardiac arrhythmias, but the impact of stroke localization on ectopic burden is uncertain.
OBJECTIVE: To examine if stroke locations are associated with PVC/PAC burden.
METHODS: We retrospectively screened 150 consecutive adults admitted to a university hospital stroke service (2023-2025); 103 met inclusion criteria (radiologically confirmed stroke, 24-hour Holter monitoring, no pre-existing arrhythmia). Stroke topography was classified by vascular territory (ACA, MCA, PCA, multifocal, brainstem), neuro-anatomical region (frontal, temporal, parietal, occipital, basal ganglia, insula, cerebellum), and hemisphere. Stroke etiology (ischemic vs. hemorrhagic) was also examined. Negative-binomial models adjusted for age, sex, hypertension, and left ventricular function quantified associations as incidence rate ratios (IRR) between stroke location and ectopic burden. Results were significant if p < 0.05.
RESULTS: Mean age was 70.8 years; 54.9% male, 62.1% with hypertension; arrhythmias occurred in 11.7%. By vascular territory, PAC burden was higher in ACA than MCA strokes (IRR 12.50) and higher in MCA than PCA strokes (IRR 8.30); PVC burden did not differ across territories. By neuro-anatomical region, PVC burden was elevated in the basal ganglia, cerebellum, and brainstem versus cortical regions; PAC burden was lowest in the frontal lobe (IRR 0.17 vs. temporal, 0.03 vs. basal ganglia, 0.01 vs. cerebellum). By hemisphere, left-sided strokes had higher PVC burden than right (IRR 1.98) and bilateral (IRR 12.33), and higher PAC burden than right-sided strokes (IRR 13.69). Ischemic and hemorrhagic strokes did not differ in ectopic burden. Several estimates carried wide confidence intervals reflecting small subgroup sizes, and should be interpreted as preliminary conclusions.
CONCLUSIONS: Post-stroke, cardiac atrial and venricular ectopy varies by the stroke lesion site in the brain.
OBJECTIVE: To examine if stroke locations are associated with PVC/PAC burden.
METHODS: We retrospectively screened 150 consecutive adults admitted to a university hospital stroke service (2023-2025); 103 met inclusion criteria (radiologically confirmed stroke, 24-hour Holter monitoring, no pre-existing arrhythmia). Stroke topography was classified by vascular territory (ACA, MCA, PCA, multifocal, brainstem), neuro-anatomical region (frontal, temporal, parietal, occipital, basal ganglia, insula, cerebellum), and hemisphere. Stroke etiology (ischemic vs. hemorrhagic) was also examined. Negative-binomial models adjusted for age, sex, hypertension, and left ventricular function quantified associations as incidence rate ratios (IRR) between stroke location and ectopic burden. Results were significant if p < 0.05.
RESULTS: Mean age was 70.8 years; 54.9% male, 62.1% with hypertension; arrhythmias occurred in 11.7%. By vascular territory, PAC burden was higher in ACA than MCA strokes (IRR 12.50) and higher in MCA than PCA strokes (IRR 8.30); PVC burden did not differ across territories. By neuro-anatomical region, PVC burden was elevated in the basal ganglia, cerebellum, and brainstem versus cortical regions; PAC burden was lowest in the frontal lobe (IRR 0.17 vs. temporal, 0.03 vs. basal ganglia, 0.01 vs. cerebellum). By hemisphere, left-sided strokes had higher PVC burden than right (IRR 1.98) and bilateral (IRR 12.33), and higher PAC burden than right-sided strokes (IRR 13.69). Ischemic and hemorrhagic strokes did not differ in ectopic burden. Several estimates carried wide confidence intervals reflecting small subgroup sizes, and should be interpreted as preliminary conclusions.
CONCLUSIONS: Post-stroke, cardiac atrial and venricular ectopy varies by the stroke lesion site in the brain.