Cardiac arrhythmias in focal epilepsy: a prospective long-term study

Patients with epilepsy are at risk of sudden unexpected death. Neurogenic cardiac arrhythmias have been postulated as a cause. Electrocardiograms (ECG) can be monitored by use of an implantable loop recorder for up to 18 months. We aimed to determine the frequency of cardiac arrhythmias in patients...

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Bibliographic Details
Published in:The Lancet (British edition) 2004-12, Vol.364 (9452), p.2212-2219
Main Authors: Rugg-Gunn, Fergus J, Simister, Robert J, Squirrell, Mark, Holdright, Diana R, Duncan, John S
Format: Article
Language:English
Subjects:
Abnormalities
Adult
Arrhythmia
Bradycardia
Bradycardia - complications
Bradycardia - diagnosis
Bradycardia - therapy
Cardiac arrhythmia
Clinical trials
Correlation analysis
Data analysis
Data processing
Death, Sudden, Cardiac - etiology
Diaries
EKG
Electrocardiography
Electrocardiography, Ambulatory
Electroencephalography
Epilepsies, Partial - complications
Epilepsies, Partial - physiopathology
Epilepsy
Female
Funding
Heart Rate
Humans
Localization
Male
Medical equipment
Middle Aged
Mortality
Neurology
Neurosurgery
Pacemaker, Artificial
Patients
R&D
Recorders
Research & development
Seizing
Seizures
Tachycardia
Telemetry
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Summary:Patients with epilepsy are at risk of sudden unexpected death. Neurogenic cardiac arrhythmias have been postulated as a cause. Electrocardiograms (ECG) can be monitored by use of an implantable loop recorder for up to 18 months. We aimed to determine the frequency of cardiac arrhythmias in patients with refractory focal seizures over an extended period. 20 patients received an implantable loop recorder at one hospital in the UK. Devices were programmed to record automatically if bradycardia (140 beats per min) were detected. Additionally, in the event of a seizure, patients and relatives could initiate ECG recording with an external activator device. Data were analysed at regular intervals and correlated with seizure diaries. More than 220 000 patient-hours were monitored over 24 months, during which ECGs were captured on implantable loop recorders in 377 seizures. One patient withdrew from the study. In 16 patients, median heart rate during habitual seizures exceeded 100 beats per min. Ictal bradycardia (
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(04)17594-6