Serial heart rate variability testing for the evaluation of autonomic dysfunction after stroke

Abstract

Background and purpose—Autonomic dysfunction has been described as a frequent complication of
stroke that could involve the cardiac, respiratory, sudomotor, and sexual systems. Cardiac autonomic dysfunction after stroke is one of the most recognized and has been described to increase the rate of mortality
and morbidity.
Methods—We report two cases of stroke—one hemorrhagic and one ischemic—and describe heart rate
variability during the patients’ hospitalizations with improvement reported for each patient several days
after stroke onset.
Results—The first case demonstrated autonomic dysfunction with severe reduction of HRV after a right
parietal hemorrhagic stroke. The second case demonstrated similar findings in a patient with acute ischemic
stroke. In both cases, normalization of heart rate variability occurred several weeks after stroke symptoms
onset and was paralleled by a dramatic improvement of the clinical status.
Conclusion—Our data established that serial HRV testing is a noninvasive tool that could be utilized as a
marker to evaluate the dynamics of acute stroke.