The aim of this prospective study was to elucidate the relationship between cardiac complications and heart rhythm variability (HRV) in 90 patients (age median 58 (53;67) years) with the sinus rhythm after ischemic stroke. 24-hr Holter monitoring 21 days after stroke was used for temporal and spectral analysis of HRV. The follow-up period lasted 23 (12; 45) months. Ten (11%) patients of this group developed acute myocardial infarction, unstable angina, acute cardiac failure or sudden cardiac death. The remaining 80 (89%) patients constituted group 2. The two groups were matched for the duration of prospective observation, sex, ischemic stroke subtype, the size and localization of brain infarction, multiplicity of focal cerebral lesions, severity of neurologic disorders (Rankin scale), the history of myocardial infarction, the presence of diabetes and chronic heart failure. Patients of group 1 were older in the end of the acute stroke period than those of group 2 (68 (61;72) and 57 (51;66) years) respectively. They, more frequently suffered CHD (stable angina) and had lower spectral characteristics of HRV (p < 0.05).