Assessment of palpitation complaints in patients with benign paroxysmal positional vertigo

The detection of cardiac arrhythmias during vertigo attacks along with the resolution of vertigo by treating the arrhythmias is defined as cardiac vertigo. The cause of palpitations that develop following attacks of non-cardiac vertigo is unknown. We aimed to investigate the effect of benign paroxysmal positional vertigo (BPPV) on the cardiac conduction system and evaluate patients' palpitation complaints using 24-hour ambulatory ECG (Holter) monitoring.

Sixty-five patients with BPPV and forty-eight healthy controls were included in the study. ECG was performed on all participants, and ECG parameters were measured. Holter monitoring was performed, and the recordings were analyzed. Evaluation of the time-domain heart rate variability (HRV) results was done.

The average age of the vertigo group was 49.1 ± 7.8 years. In terms of demographic or laboratory data, there was no statistically significant difference between the groups (p>0.05). The study group's ECG parameters, including Pd, TpTe, and TpTec, were longer, and the TpTe/QT and TpTe/QTc ratios were higher (p<0.05). Holter monitoring detected abnormal rhythms in 41 (63%) of the study group patients and three (6.2%) of the control group patients. The SDNN, LF, and LF/HF values, which are known as HRV markers, were significantly different in the vertigo group compared to the control group (p<0.001).

This study revealed that the risk of arrhythmias increased following attacks of BPPV in patients without a known history of cardiac vertigo.