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Ictal asystole: A benign condition?
Author(s) -
Schuele Stephan U.,
Bermeo Adriana C.,
Locatelli Eduardo,
Burgess Richard C.,
Lüders Hans O.
Publication year - 2008
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2007.01330.x
Subject(s) - asystole , epilepsy , bradycardia , medicine , ictal , heart rate , anesthesia , cardiology , vasovagal syncope , autonomic nervous system , syncope (phonology) , blood pressure , psychiatry
SummaryIctal asystole (IA) has been implicated as a preventable cause of sudden unexplained death in epilepsy presumably provoked by a direct autonomic effect of the electrical stimulus on the heart. An electronic database search of patients with IA was performed comparing heart rate (HR) characteristics to a group of patients with vasovagal asystole. IA was seen in eight patients, all with temporal lobe epilepsy. No statistical difference was found in duration of asystole, bradycardia, and baseline HR characteristics except of a higher HR acceleration postasystole in the controls. None of the six patients with IA who underwent pacemaker implantation had recurrence of asystolic events during mean follow‐up of 5 years. This study in a small group of patients suggests that the epileptic activation leading to IA is possibly mediated through a transient increase in vagal tone and not by a direct autonomic effect on the heart.