What cardiac arrhythmias are associated with CNS disease?
A number of CNS disorders, including subarachnoid hemorrhage, cerebral infarction and hemorrhage, brain tumors, and head injury, may cause a variety of supraventricular and ventricular arrhythmias unrelated to the any underlying cardiac disease.
The incidence of cardiac arrhythmias increases if there is more than one infarction site and is highest in subarachnoid hemorrhage.
The most common arrhythmia following stroke is atrial fibrillation, whereas in intracranial hemorrhage the incidence of ventricular tachycardia is high.
The occurrence of arrhythmias may further compromise the prognosis of the CNS disease: 4% to 5% of sudden deaths in patients with subarachnoid hemorrhage are attributed to arrhythmias.
Arrhythmias occur because of an imbalance between sympathetic and parasympathetic influences on the heart, presumably from an enhanced release of peripheral catecholamines triggered by the central lesion.
