| Title: |
Incidence and Types of Cardiac Arrhythmias in the Peri-Ictal Period in Patients Having a Generalized Convulsive Seizure |
| Authors: |
Vilella, L; Miyake, CY; Chaitanya, G; Hampson, JP; Omidi, SJ; Ochoa-Urrea, M; Talavera, B; Mancera, O; Hupp, NJ; Hampson, JS; Rani, MRS; Lacuey, N; Tao, S; Sainju, RK; Friedman, D; Nei, M; Scott, CA; Gehlbach, B; Schuele, SU; Ogren, JA; Harper, RM; Diehl, B; Bateman, LM; Devinsky, O; Richerson, GB; Zhang, GQ; Lhatoo, SD |
| Source: |
Neurology , 103 (1) , Article e209501. (2024) |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2024 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Humans; Female; Male; Adult; Arrhythmias; Cardiac; Incidence; Middle Aged; Prospective Studies; Electroencephalography; Sudden Unexpected Death in Epilepsy; Seizures; Epilepsy; Generalized; Aged; Young Adult; Electrocardiography; Adolescent |
| Description: |
BACKGROUND AND OBJECTIVES: Generalized convulsive seizures (GCSs) are the main risk factor of sudden unexpected death in epilepsy (SUDEP), which is likely due to peri-ictal cardiorespiratory dysfunction. The incidence of GCS-induced cardiac arrhythmias, their relationship to seizure severity markers, and their role in SUDEP physiopathology are unknown. The aim of this study was to analyze the incidence of seizure-induced cardiac arrhythmias, their association with electroclinical features and seizure severity biomarkers, as well as their specific occurrences in SUDEP cases. METHODS: This is an observational, prospective, multicenter study of patients with epilepsy aged 18 years and older with recorded GCS during inpatient video-EEG monitoring for epilepsy evaluation. Exclusion criteria were status epilepticus and an obscured video recording. We analyzed semiologic and cardiorespiratory features through video-EEG (VEEG), electrocardiogram, thoracoabdominal bands, and pulse oximetry. We investigated the presence of bradycardia, asystole, supraventricular tachyarrhythmias (SVTs), premature atrial beats, premature ventricular beats, nonsustained ventricular tachycardia (NSVT), atrial fibrillation (Afib), ventricular fibrillation (VF), atrioventricular block (AVB), exaggerated sinus arrhythmia (ESA), and exaggerated sinus arrhythmia with bradycardia (ESAWB). A board-certified cardiac electrophysiologist diagnosed and classified the arrhythmia types. Bradycardia, asystole, SVT, NSVT, Afib, VF, AVB, and ESAWB were classified as arrhythmias of interest because these were of SUDEP pathophysiology value. The main outcome was the occurrence of seizure-induced arrhythmias of interest during inpatient VEEG monitoring. Moreover, yearly follow-up was conducted to identify SUDEP cases. Binary logistic generalized estimating equations were used to determine clinical-demographic and peri-ictal variables that were predictive of the presence of seizure-induced arrhythmias of interest. The z-score test for 2 population proportions ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10196931/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10196931/1/DIEHL%20WNL-2023-005213R2-Vilella-MS.pdf; https://discovery.ucl.ac.uk/id/eprint/10196931/ |
| Rights: |
open |
| Accession Number: |
edsbas.EE010179 |
| Database: |
BASE |