Incidence and Types of Cardiac Arrhythmias in the Peri-Ictal Period in Patients Having a Generalized Convulsive Seizure
Laura Vilella, Christina Y. Miyake, Ganne Chaitanya, Johnson P. Hampson, Shirin Jamal Omidi, Manuela Ochoa‐Urrea, Blanca Talavera, Oscar Mancera, Norma J. Hupp, Jaison S. Hampson, M.R. Sandhya Rani, Nuria Lacuey, Shiqiang Tao, Rup K. Sainju, Daniel Friedman, Maromi Nei, Catherine Scott, Brian K. Gehlbach, Stephan Schuele, Jennifer A. Ogren, Ronald M. Harper, Beate Diehl, Lisa M. Bateman, Orrin Devinsky, George B. Richerson, Guo‐Qiang Zhang, Samden Lhatoo
Abstract
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: -score test for 2 population proportions was used to test whether the proportion of seizures and patients with postconvulsive ESAWB or bradycardia differed between SUDEP cases and survivors. RESULTS: > 0.05). DISCUSSION: Markers of seizure severity are not related to seizure-induced arrhythmias of interest, suggesting that other factors such as occult cardiac abnormalities may be relevant for their occurrence. Seizure-induced ESAWB and bradycardia were more frequent in SUDEP cases, although this observation was based on a very limited number of SUDEP patients. Further case-control studies are needed to evaluate the yield of arrhythmias of interest along with respiratory changes as potential SUDEP biomarkers.