And the Beat Goes on…Heart Rate Variability After Spontaneous Intracranial Hemorrhage

Excerpt

Spontaneous intracranial hemorrhage (sICH) accounts for up to 25% of all reported strokes globally and its incidence varies significantly with race and ethnicity [1]. Despite advancements in diagnosis and identification of important risk factors, these patients continue to have a high mortality and those who survive often endure significant disability. As neurointensivists, we focus our efforts on early identification of patients who may benefit from medical or surgical therapies and prevention of predictable secondary injury. In this issue of Neurocritical Care, Swor et al. [2] reported a retrospective analysis of prospectively collected data in patients presenting to their institution with sICH. The authors analyzed data collected using routine electrocardiogram studies (performed during the first 24 h) to determine heart rate variability (HRV) using two previously validated methods. The calculated indices of HRV, which are assumed to represent a secondary measure of autonomic nervous system activity, were then entered into a binary logistic regression model to predict fever. They report that patients who present with sICH and subsequently develop fever during the first 2 weeks of their hospitalization have a significantly lower mean HRV. …