Cardiac arrhythmias six months following traumatic spinal cord injury,The Journal of Spinal Cord Medicine

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Cardiac arrhythmias six months following traumatic spinal cord injury
The Journal of Spinal Cord Medicine ( IF 1.8 ) Pub Date : 2021-07-22 , DOI: 10.1080/10790268.2021.1950453
Shane J T Balthazaar ₁ , Morten Sengeløv _{2,

3,

4} , Kim Bartholdy ₂ , Lasse Malmqvist _{2,

5} , Martin Ballegaard _{4,

5,

6} , Birgitte Hansen ₂ , Jesper Hastrup Svendsen _{2,

3} , Anders Kruse ₇ , Karen-Lise Welling ₈ , Andrei V Krassioukov _{9,

10,

11} , Fin Biering-Sørensen _{2,

4} , Tor Biering-Sørensen _{2,

3,

4}

Affiliation

Department of Cardiology, Vancouver General Hospital, Vancouver Coastal Health, Vancouver, British Columbia (BC), Canada.
Clinic for Spinal Cord Injuries, Rigshospitalet, Copenhagen, Denmark.
Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Neurophysiology, Rigshopitalet, Copenhagen, Denmark.
Department of Neurology, Zealand University Hospital at Roskilde, Roskilde, Denmark.
Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen, Denmark.
Department of Neuroanesthesiology, Rigshospitalet, Copenhagen, Denmark.
International Collaboration on Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, BC, Canada.
Department of Medicine, Division of Physical Medicine and Rehabilitation, Vancouver, BC, Canada.
Spinal Cord Program, GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, BC, Canada.

Objective

To investigate the incidence of cardiac arrhythmias at six months following traumatic spinal cord injury (SCI) and to compare the prevalence of arrhythmias between participants with cervical and thoracic SCI.

Design

A prospective observational study using continuous twenty-four-hour Holter monitoring.

Setting

Inpatient rehabilitation unit of a university research hospital and patient home setting.

Participants

Fifty-five participants with acute traumatic SCI were prospectively included. For each participant, the SCI was characterized according to the International Standards for Neurological Classification of SCI by the neurological level and severity according to the American Spinal Injury Association Impairment Scale.

Outcome measures

Comparisons between demographic characteristics and arrhythmogenic occurrences as early as possible after SCI (4 ± 2 days) followed by 1, 2, 3, 4 weeks and 6 month time points of Holter monitoring.

Results

Bradycardia (heart rate [HR] <50 bpm) was present in 29% and 33% of the participants with cervical (C1–C8) and thoracic (T1–T12) SCI six months after SCI, respectively. The differences in episodes of bradycardia between the two groups were not significant (P < 0.54). The mean maximum HR increased significantly from 4 weeks to 6 months post-SCI (P < 0.001), however mean minimum and maximum HR were not significantly different between the groups at the six-month time point. There were no differences in many arrhythmias between recording periods or between groups at six months.

Conclusions

At the six-month timepoint following traumatic SCI, there were no significant differences in occurrences of arrhythmias between participants with cervical and thoracic SCI compared to the findings observed in the first month following SCI.

中文翻译：

外伤性脊髓损伤后 6 个月的心律失常

客观的

调查创伤性脊髓损伤 (SCI) 后 6 个月心律失常的发生率，并比较颈椎和胸椎 SCI 参与者心律失常的发生率。

设计

一项使用连续 24 小时动态心电图监测的前瞻性观察研究。

环境

大学研究医院的住院康复单位和患者家庭环境。

参与者

前瞻性纳入了 55 名患有急性创伤性 SCI 的参与者。对于每位参与者，根据美国脊髓损伤协会损伤量表的神经学水平和严重程度，根据国际脊髓损伤神经学分类标准对 SCI 进行表征。

结果措施

SCI 后（4 ± 2 天）及随后 1、2、3、4 周和 6 个月的动态心电图监测时间点尽早比较人口统计学特征和致心律失常发生率。

结果

SCI 后 6 个月，颈椎 (C1-C8) 和胸椎 (T1-T12) SCI 的参与者分别有 29% 和 33% 出现心动过缓（心率 [HR] <50 bpm）。两组心动过缓发作次数差异无统计学意义（P < 0.54）。平均最大 HR 在 SCI 后 4 周至 6 个月显着增加（P < 0.001），但在 6 个月时间点各组之间的平均最小和最大 HR 没有显着差异。在记录期之间或在六个月时的组之间，许多心律失常没有差异。