Routine Interictal EEG Recording Should be Performed Together with Simultaneous Two-Lead ECG Recording

Abstract

We aimed to evaluate the contribution of simultaneous electrocardiography (ECG) recording during routine interictal electroencephalography (EEG) recording in patients with seizures or epilepsy and therefore to provide evidence-based data on this subject. Patients with interictal cardiac arrhythmia on routine EEG-ECG recordings were determined and evaluated based on cardiologic and neurologic findings. Out of 1,078 patients aged between 5 and 16 years (mean: 10.2 ± 3.2), 9 (0.08%) patients were found to have an arrhythmia. Six patients had both epilepsy and cardiac arrhythmia (premature ventricular contractions [PVCs] in 5; Wolff-Parkinson-White [WPW] in 1 patient) and the remaining three patients had nonepileptic paroxysmal events (NPEs) and arrhythmia (PVC in 2; WPW in 1). Three patients had other diseases (neurofibromatosis type 1, tuberous sclerosis, and congenital heart disease status postsurgery). Cardiac arrhythmia required radiofrequency ablation or antiarrhythmic drug treatment in two patients with epilepsy and also two patients with NPE; however, it improved with no specific treatment in the remaining five patients. NPE was not related to arrhythmia in one of three patients with NPE. Our study suggests that routine interictal EEG-ECG recording provides a valuable and feasible opportunity to reveal unnoticed or new-onset cardiac arrhythmias. Therefore, ECG should be recorded simultaneously during routine interictal EEG recordings. Cardiac arrhythmias detected by routine interictal EEG-ECG recordings would require arrhythmia treatment in nearly half of the patients.

Keywords

arrhythmia - nonepileptic paroxysmal events - electroencephalography - electrocardiography - epilepsy - seizure - children

Ethical Approval

All procedures performed in this study were following the ethical standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its comparable ethical standards.

Authors' Contributions

K.Y. made the concept and design of the study. All authors contributed to the patient enrolment and collection of samples. K.Y. wrote the article after all of the authors participated in the interpretation of the data. After all of the authors reviewed the manuscript and decided to submit it for publication, the article was corresponded by K.Y. All authors participated in the final edited version of the article. All authors will act as guarantors for the paper.

Publication History

Received: 25 November 2021

Accepted: 26 May 2022

Article published online:
02 August 2022

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