In epilepsy patients during video-electroencephalographic monitoring there are various electrocardiographic (ECG) changes during the epileptic seizure, sometimes remaining at postictal period as well. In the literature, various cardiac rhythm and conduction disorders are described, ventricular and supraventricular disorders, ST segment shifts. Some among these might be life-threatening, probably leading to unexplained sudden death in epilepsy. In the review, we focus on the most common ECG changes in patients with ongoing epileptic seizures.
Aim.To assess the characteristics and prevalence of cardiac rhythm disorders in epilepsy patients during the iktal period, by long term ECG monitoring.Material and methods.To the study, 79 patients included, age 18 to 51 y. o. with confirmed diagnosis of focal epilepsy with continuing attacks regardless the antiepilepsy treatment. For rhythm disorder screening, all patients underwent implanting of subcutaneous ECG monitors.Results.Disorders of cardiac rhythm and conduction during the iktal period were found in 88,61% cases. Most prevalent were sinus tachycardia (59,5%, 47 cases), cardiac rhythm and conduction disorders (29%, 23 cases). In 9 cases (11,4%) there were no cardiac rhythm and conduction disorders registered. Also, the probable predictors found, of the disorders of cardiac rhythm in epilepsy patients. Patients gender, type of attacks, frequency, circadian specifics were the markers influencing the rate of iktal cardiac rhythm changes.Conclusion.Sinus tachycardia, rhythm and conduction disorders are registered in most of patients during the iktal period and significantly more common in males, the patients with bilateral tonic and clonic seizures, serial course of the attacks and in the patients with sleep-related seizures. Evaluation of antiepilepsy treatment influence on the prevalence of iktal rhythm and conduction disorders did not reveal significant difference for none of the drug groups. Also, there was no significant differences in comparison of the studied parameters for polyand monotherapy by anticonvulsants.
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