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Published online by Cambridge University Press: 27 June 2018
Background: Strokes can cause a variety of cardiovascular complications. The underlying mechanisms are largely unknown but there is evidence that dysautonomia plays a role in stroke induced-heart injury (SIHI) and arrhythmias triggered by damage of specific brain regions involved in the autonomic regulation of cardiac functions. Understanding these mechanisms could aid in preventing these cardiovascular consequences. We hypothesize that compared to -patients with sinus rhythm (SR) or with cardiogenic atrial fibrillation known before the stroke (cKAF) or diagnosed after the stroke (cAFDAS), those with neurogenic AFDAS (nAFDAS) will show a specific pattern of autonomic functioning. Methods: We will prospectively evaluate 200 ischemic stroke patients at the London Health Sciences Center University Hospital. Participants will undergo continuous electrocardiographic monitoring during 14 days. Based on pre-specified criteria, patients with AFDAS will be classified into presumably neurogenic vs cardiogenic. We will assess autonomic function within 14 days after stroke onset by using the Autonomic Reflex Screening. We will compare markers of cardiac dysfunction with autonomic changes, as well as specific stroke topographies for SR, cKAF, cAFDAS, and nAFDAS. Results: We are currently performing an interim analysis. Conclusions: Characterizing the autonomic changes that occur after ischemic stroke and their relationship with heart injury will help to advance knowledge on the pathophysiology of SIHI.