Prehospital heart rate variability in patients with suspicion of acute stroke: predictive and diagnostic value.

Background: Autonomic nervous system (ANS) dysfunction
is common in acute stroke and is believed to influence
outcome through increased blood pressure variability,
impaired cerebral autoregulation, cardiovascular complications
and secondary brain injury due to inflammation,
hyperglycemia and blood brain barrier dysfunction. Heart
rate variability (HRV) has been investigated as a parameter
of ANS and a reduction has been reported in association with stroke severity, early and late complications, dependency
and mortality. In acute stroke, prehospital diagnosis
of reduced HRV may have diagnostic and possibly therapeutic
value. Our research group has previously demonstrated
the feasibility and reliability of in-ambulance HRV
acquisition in an explorative study and demonstrated the
correlation between prehospital frequency domain parameters
and stroke outcome.
Methods: The objective of this study is to evaluate the
predictive and diagnostic value of prehospital HRV in
patients with suspicion of acute stroke in an observational,
prospective, multi-center clinical trial. HRV will be registered
during transportation by emergency medical services
of patients with prehospital suspicion of acute
stroke, using a non-invasive, 2 lead ECG registration
device. Assessment will included time domain, frequency
domain, nonlinear and time-frequency analysis. Patients
will be included within 24 hours of symptom onset.
Patients with pacemaker activity or non-sinus rhythm
during registration will be excluded. Recordings with presence
of ectopic beats and/or noise in over 25% of the
fragment will also be excluded from further analysis.
Results: Not available.
Conclusions: This observational, prospective, multicenter
clinical trial will assess the predictive and diagnostic
value of HRV in patients with pre-hospital suspicion of
acute stroke.

Jaar van publicatie:2016

Trefwoorden:ANS dysfunction, acute stroke