Detection and Significance of Nonsustained Ventricular Tachycardia in a Post-Stroke Population

Clinical guidelines recommend cardiac rhythm monitoring in post-stroke patients. This study sought to assess the prevalence and significance of nonsustained ventricular tachycardia (NSVT) in patients who have had an ischemic stroke or transient ischemic attack (TIA). The CAMPS (Cardiac Ambulatory Monitoring Post Stroke) study was composed of post-stroke or TIA patients who were referred for ambulatory cardiac rhythm monitoring. Between 2019 and 2023, 752 patients completed cardiac monitoring within 1 year of the ischemic event. We evaluated the association between the presence of NSVT and the risk of subsequent stroke, cardiac events, or death. Patients were monitored for a mean of 19 ± 7 days, and NSVT was observed in 164 patients (22%). Compared with patients who did not have NSVT, those with NSVT were older, more likely to be male, smoke, and have a higher prevalence of coronary heart disease. Patients with NSVT had a higher risk of subsequent stroke (HR: 2.65; 95% CI: [1.74-4.02]), cardiac events (HR: 2.25; 95% CI: [1.40-3.64]), and death (HR: 1.87; 95% CI: [1.12-3.15]). These estimates remained significant after adjustment for demographics and clinical factors: subsequent stroke (HR: 2.50; 95% CI: [1.59-3.93]), cardiac events (HR: 1.86; 95% CI: [1.11-3.11]), and death (HR: 1.90; 95% CI: [1.09-3.31]). In this exploratory analysis, a higher NSVT burden was associated with increased risk of adverse events. NSVT in patients with recent stroke or TIA is independently associated with a 2- to 3-fold increased risk of subsequent stroke, cardiac events, and death after controlling for demographics and clinical factors.