PAUL F. WALTER, M.D.; SAM D. REID JR., M.D.; NANETTE KASS WENGER, M.D.
The diagnostic value of a continuous 10-hr tape-recorded electrocardiogram was evaluated in 39 ambulatory patients with symptoms of cerebral ischemia. Twenty-eight had symptoms of diffuse cerebrovascular insufficiency (dizziness, giddiness or syncope); 11 had classic transient cerebral ischemic attacks. No patient had a prior significant arrhythmia or conduction abnormality diagnosed clinically or by standard electrocardiogram. Patients with bradycardia below 40/min, tachycardia over 150/min, or high-grade atrioventricular (AV) block were considered to have arrhythmias capable of producing their symptoms. Ten of the 39 patients had one of the above arrhythmias; in seven of these the arrhythmias correlated with symptoms. Eight of the 10 "positives" occurred in patients with diffuse cerebrovascular insufficiency; 7 of these had supraventricular tachycardia, and 1 had sinus bradycardia. Specific antiarrhythmic therapy gave an excellent result in five patients and fair improvement in three.
WALTER PF, REID SD, WENGER NK. Transient Cerebral Ischemia Due to Arrhythmia. Ann Intern Med. 1970;72:471–474. doi: 10.7326/0003-4819-72-4-471
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Published: Ann Intern Med. 1970;72(4):471-474.
Cardiology, Neurology, Rhythm Disorders and Devices.
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