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Published on: February 28, 2012
Ictal asystole: an indication for pacemaker implantation and emerging cause of sudden death
Samuel G Wittekind1, Octavian Lie, Stephen Hubbard
1Pediatric Residency Program, University of Washington, Seattle, Washington 98195, USA.
Abstract:
Ictal asystole is being recognized as a potential mechanism of sudden unexplained death in epilepsy (SUDEP). We report a case of a patient without known cardiac disease presenting with ictal asystole resulting in syncope, trauma, and need for pacemaker implantation. The management of ictal asystole is also briefly reviewed. This case is notable for the asystolic episode wholly captured on video-electroencephalogram/electrocardiogram, the serious risk of trauma and death posed to the patient, and its implications for the mechanism of ictal asystole. This report will alert physicians to the possibility of ictal arrhythmias as a cause of syncope and SUDEP in vulnerable patients.
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