Relationship between seizure episode and sudden cardiac arrest in patients with epilepsy: A community-based study

Eric Stecker, Kyndaron Reinier, Audrey Uy-Evanado, Carmen Teodorescu, Harpriya Chugh, Karen Gunson, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Among patients with epilepsy, sudden cardiac arrest (SCA) is a major cause of death. It is commonly thought that SCA in epilepsy occurs after a seizure, though the strength of evidence supporting this is limited. We sought to evaluate the relationship between seizures and SCA in patients with epilepsy. Methods and Results: From the ongoing Oregon Sudden Unexpected Death Study, cases of SCA identified using prospective, multisource ascertainment (Portland metropolitan area, Oregon; population ≈1 million; February 1, 2002, to March 1, 2012) were evaluated for history of epilepsy. In the subset with witnessed SCA, clinical presentations were analyzed for evidence of seizure activity immediately before the event as well as lifetime clinical history, including nature of seizures before SCA. Only 34% of patients with history of epilepsy and a witnessed arrest had evidence of seizure activity before the arrest. Rates of survival to hospital discharge after attempted resuscitation were 2.7% in patients with history of epilepsy versus 11.9% for patients without epilepsy (P=0.014). Patients with epilepsy had a significantly lower rate of presentation with ventricular tachycardia/ventricular fibrillation as opposed to pulseless electrical activity/asystole (epilepsy, 26%; no epilepsy, 44%; P=0.002), despite nearly identical response times. Conclusions: In the majority (66%) of epilepsy patients, there was no relationship between seizure and SCA, implying that SCA in epilepsy patients often may not involve seizure as a trigger. The significantly worse rate of survival from SCA in epilepsy patients warrants urgent investigation.

Original languageEnglish (US)
Pages (from-to)912-916
Number of pages5
JournalCirculation: Arrhythmia and Electrophysiology
Volume6
Issue number5
DOIs
StatePublished - Oct 2013

Fingerprint

Sudden Cardiac Death
Epilepsy
Seizures
Survival Rate
Ventricular Fibrillation
Ventricular Tachycardia
Sudden Death
Heart Arrest
Resuscitation
Reaction Time
Cause of Death

Keywords

  • Cardiac
  • Death
  • Epilepsy
  • Seizures
  • Sudden

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Relationship between seizure episode and sudden cardiac arrest in patients with epilepsy : A community-based study. / Stecker, Eric; Reinier, Kyndaron; Uy-Evanado, Audrey; Teodorescu, Carmen; Chugh, Harpriya; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 6, No. 5, 10.2013, p. 912-916.

Research output: Contribution to journalArticle

Stecker, Eric ; Reinier, Kyndaron ; Uy-Evanado, Audrey ; Teodorescu, Carmen ; Chugh, Harpriya ; Gunson, Karen ; Jui, Jonathan ; Chugh, Sumeet S. / Relationship between seizure episode and sudden cardiac arrest in patients with epilepsy : A community-based study. In: Circulation: Arrhythmia and Electrophysiology. 2013 ; Vol. 6, No. 5. pp. 912-916.
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