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Complete atrio-ventricular conduction block during complex partial seizure
1Department of Medicine, University of Otago, Dunedin Public Hospital, New Zealand.
Insights
Epileptic seizures can cause cardiac arrhythmias, which are often misdiagnosed as primary heart problems. This study demonstrates a case where a seizure led to heart block, confirming the secondary nature of the arrhythmia.
Area of Science:
- Cardiology
- Neurology
- Clinical Electrophysiology
Background:
- Cardiac arrhythmias are a known cause of epileptic seizures.
- Conversely, epileptic seizures causing cardiac arrhythmias are less recognized.
- Arrhythmias are frequently presumed to be of primary cardiac origin.
Observation:
- This paper details a patient experiencing complete atrioventricular (AV) heart-block.
- The heart block occurred during a partial complex seizure.
- Simultaneous electroencephalogram (EEG) and electrocardiogram (ECG) monitoring was employed.
Findings:
- The simultaneous EEG/ECG monitoring confirmed the secondary nature of the bradyarrhythmia.
- The cardiac event (heart block) was a consequence of the epileptic seizure.
- This challenges the common assumption of primary cardiac etiology for arrhythmias in such contexts.
Implications:
- Highlights the importance of considering neurological events as a cause of cardiac arrhythmias.
- Suggests the need for integrated EEG/ECG monitoring in specific clinical scenarios.
- Improves understanding of the interplay between cardiac and neurological systems during seizures.
Abstract:
Cardiac arrhythmias are a well known cause of epileptic seizures. Epileptic seizures resulting in cardiac arrhythmias are less well recognised and cardiac arrhythmias are commonly presumed to be of primary cardiac origin. This paper describes a patient with complete AV heart-block during a partial complex seizure. Simultaneous EEG/ECG monitoring was used to show the secondary nature of the bradyarrhythmia.