Clinically significant bradyarrhythmias in video-EEG patients

The prevalence of patients thought to have epilepsy who are ultimately diagnosed with asystole or bradyarrhythmias not associated with seizures is currently unknown. We studied a tertiary referral population to determine the rate of clinically significant asystole or bradyarrhythmias in patients being evaluated for possible epilepsy in 2 inpatient epilepsy monitoring units (EMU).

A retrospective cohort of 1606 consecutive patients admitted for video-EEG monitoring at University of New Mexico Hospital from January 2000 to July 2005 and Mayo Clinic Florida from September 2005 to August 2009 was reviewed for clinical presentation and outcome of video-EEG and EKG monitoring. All patients included in the final analysis (n=1433) were admitted with a diagnosis of "possible seizures".

The majority of subjects were under the age of 20 and 10% of subjects were over age 50. The rate of significant cardiac bradyarrhythmias was 0.3% (4/1433). Three of the four subjects with cardiac arrhythmias had symptom onset in childhood. One subject died during the evaluation.

The rate of patients admitted for video-EEG monitoring who are ultimately diagnosed with asystole and bradyarrhythmias not associated with epilepsy is low. Symptom may begin in childhood.