Electrocardiographic Changes and Its Correlation with Three Months Outcome in Patients of Stroke

Background Stroke is on the rise in India with great impact on morbidity and mortality. One of the factors associated with poor outcome among stroke patients are some electrocardiographic (ECG) changes resulting from massive autonomic discharge that interferes with cardiac autonomic control. Objective To determine ECG changes and three months outcomes of patients admitted with new onset stroke at a tertiary care teaching hospital in western India. Methodology 160 patients with new onset stroke regardless of its type were enrolled in the study. All eligible patients underwent 12 lead resting ECGs. These patients were then followed up at one and three months from the day of enrollment for determination of their survival/morbidity and mortality outcomes. Results Nine ECG patterns were identified out of which left ventricular hypertrophy (LVH), ischemic changes and QT Prolongation were dominant (83.1%, 63.1% and 50.6% respectively). QT prolongation and Ischemic changes were found to be statistically significant in predicting outcomes at 1-month and at 3-months (p <0.001 and 0.036 respectively). Patients with haemorrhagic stroke were more likely to present with multiple ECG changes. Those with QT prolongation and Ischemic changes had poorer outcomes than those without these changes. Patients with more than three changes had poorer outcomes as compared to those with less than three (p 0.018) with risk of three times likely-hood of mortality at three months. Conclusion Bed side ECG was a significant tool in predicting poor outcomes. ECG patterns such as QT-prolongation and Ischemic changes were associated with poor outcomes at three months, irrespective of co-morbid conditions. Some ECG changes such as QT-prolongation were highly predictive of haemorrhagic stroke.