P10-F READER: Reporting ECG abnormalities during EEG recording – A retrospective analysis

• Published in: Clinical neurophysiology 2019-07, Vol.130 (7), p.e69-e69
• Main Authors: Gough, Brogan, Hoggins, Christine, Donkin, Rob, Montes, Vizmary
• Format: Article
• Language: English
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2019.04.463

Recording electrocardiogram (ECG) during an electroencephalogram (EEG) is common practice despite physiologists receiving no formal ECG training. ECG abnormalities may require urgent attention. In a remote department without clinicians, responsibility for ‘flagging-up’ concerning ECGs falls on physiologists. This retrospective analysis explores the current practice and consequential outcomes of reporting ECG abnormalities in EEGs. EEG reports, clinician letters and cardiology investigations were collated retrospectively, using a convenience sample of 13 outpatients (11–74 years) who had an EEG that featured an unspecified ECG ‘irregularity’ noted by the physiologist. EEG referral reasons varied from transient-loss of consciousness to a range of possible seizure types. 12 of the 13 EEG reports included ECG ‘irregularities’ noted by the physiologist. 3 cases were confirmed in consultant reports, 2 included both a physiologist and consultant mention of the ECG. Only 1 patient demonstrated clinical changes during the test. Average time from for a diagnostic report was 29 days post-EEG. 3 of 13 patients underwent concurrent cardiology investigations. ECG changes were not included in clinician result letters without mention in diagnostic reports. Two patients underwent ambulatory ECG’s and Echocardiograms directly following EEG results. Physiologist reporting of ECGs highlighted several possible ‘false positives’ determined un-noteworthy by consultants. Current waiting times for results in a remote department leaves physiologists untrained in ECG interpretation to ‘flag up’ potential abnormalities. Consequently, physiologist roles are expanding and systems must be in place to assure patient safety. These preliminary findings raise awareness of the issues regarding ECG abnormalities in EEG.