Association between insular involvement and ECG abnormalities in ischemic stroke: a systematic review and meta-analysis.
Nobel Budiputra, I Wayan Widyantara
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis examined whether insular involvement in ischemic stroke is associated with ECG abnormalities, using cohort and cross-sectional studies comparing patients with and without insular involvement. Nine studies including 2553 patients were reviewed. Insular stroke was associated with higher odds of composite ECG abnormalities (OR 1.87 (1.15-3.03), p = 0.01), with findings particularly indicating atrial fibrillation and QTc prolongation. Conduction abnormalities did not differ significantly. An exploratory analysis of two studies suggested rhythm disturbances may be more prevalent with right-sided insular involvement.
Key findings
- Composite ECG abnormalities were more likely with insular involvement (OR 1.87 (1.15-3.03), p = 0.01).
- Atrial fibrillation was more frequent in insular stroke (OR 2.86 (1.52-5.38), p = 0.001).
- QTc prolongation was more frequent with insular involvement (RR 1.56 (1.25-1.94), p < 0.0001).
- No significant difference was observed in conduction abnormalities; right-sided rhythm findings came from an exploratory analysis of two studies.
Why it matters
The findings link insular involvement in ischemic stroke with rhythm and repolarization abnormalities, highlighting a potential cardiac dimension of stroke presentation. Recognising this association may inform clinical awareness of ECG findings in this population, while the evidence does not establish that insular injury causes these abnormalities.
What to keep in mind
The evidence came from nine cohort and cross-sectional studies, with low to moderate risk of bias; the right-versus-left analysis was exploratory and based on two studies.