Cardiac arrhythmias in patients with focal and generalised epilepsy undergoing ambulatory electroencephalographic and electrocardiographic monitoring

Area of Science:

• Neurology
• Cardiology
• Clinical Research

Background:

• Epilepsy is potentially linked to cardiac arrhythmias, but specific data across epilepsy types remain unclear.
• Understanding the relationship between epilepsy subtypes and cardiac events is crucial for patient management.

Purpose of the Study:

• To investigate the incidence and types of cardiac arrhythmias in patients with focal versus generalized epilepsy.
• To identify risk factors associated with cardiac arrhythmias in epilepsy patients.

Main Methods:

• Utilized continuous home-based ambulatory video-electroencephalographic (EEG)-electrocardiographic (ECG) monitoring (AVEEM) in 24 Australian sites (2020-2023).
• Evaluated 866 patients with focal epilepsy and 274 with generalized epilepsy, collecting demographic, epilepsy type, and cardiac arrhythmia data.
• Employed logistic regression to analyze associations between risk factors and cardiac arrhythmias.

Main Results:

• Focal epilepsy patients (32%) had significantly more cardiac arrhythmias than generalized epilepsy patients (15%; p=0.04).
• Temporal lobe epilepsy showed higher arrhythmia rates (35%) compared to extra-temporal focal epilepsy (20%; p=0.006).
• Increased age was the sole significant predictor of cardiac arrhythmias on multivariable analysis (p < 0.001).

Conclusions:

• Focal epilepsy is associated with a higher incidence of cardiac arrhythmias, primarily driven by older age.
• Long-term ambulatory EEG-ECG monitoring is a feasible method for real-world assessment of cardiac arrhythmias in epilepsy patients.