Cardiac arrhythmias associated with spinal cord injury

Abstract

Context/Objectives

To review the current literature to reveal the incidence of cardiac arrhythmias and its relation to spinal cord injury (SCI).

Methods

Data source: MEDLINE database, 304 hits, and 32 articles were found to be relevant. The relevant articles all met the inclusion criteria: (1) contained original data (2) on cardiac arrhythmias (3) in humans with (4) traumatic SCI.

Results

In the acute phase of SCI (1–14 days after injury) more cranial as well as more severe injuries seemed to increase the incidence of bradycardia. Articles not covering the first 14 days after injury, thus describing the chronic phase of SCI, showed that individuals with SCI did not have a higher incidence of cardiac arrhythmias compared with able-bodied controls. Furthermore, their heart rate did not differ significantly. Penile vibro-stimulation was the procedure investigated most likely to cause bradycardia, which in turn was associated with episodes of autonomic dysreflexia. The incidence of bradycardia was found to be 17–77% for individuals with cervical SCI. For individuals with thoracolumbar SCI, the incidence was 0–13%.

Conclusion

Bradycardia was commonly seen in the acute stage after SCI as well as during procedures such as penile vibro-stimulation and tracheal suction. These episodes of bradycardia were seen more often in individuals with cervical injuries. Longitudinal studies with continuous electrocardiogram recordings are needed to uncover the true relation between cardiac arrhythmias and SCI.

Keywords:

• Cardiac arrhythmia
• Bradycardia
• Tachycardia
• Spinal cord injuries
• Electrocardiogram
• Vibro-stimulation
• Tracheal suction
• Tracheal intubation
• Atrial fibrillation
• Autonomic dysreflexia