Sudden cardiac arrest in people with epilepsy in the community

Robert J. Lamberts, Marieke T. Blom, Merel Wassenaar, Abdennasser Bardai, Frans S. Leijten, Gerrit Jan De Haan, Josemir W. Sander, Roland D. Thijs, Hanno L. Tan

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Objective: To ascertain whether characteristics of ventricular tachycardia/fibrillation (VT/VF) differed between people with epilepsy and those without and which individuals with epilepsy were at highest risk. Methods: We ascertained 18 people with active epilepsy identified in a community-based registry of sudden cardiac arrest (SCA) with ECG-confirmed VT/VF (cases). We compared them with 470 individuals with VT/VF without epilepsy (VT/VF controls) and 54 individuals with epilepsy without VT/VF (epilepsy controls). Data on comorbidity, epilepsy severity, and medication use were collected and entered into (conditional) logistic regression models to identify determinants of VT/VF in epilepsy. Results: In most cases, there was an obvious (10/18) or presumed cardiovascular cause (5/18) in view of preexisting heart disease. In 2 of the 3 remaining events, near-sudden unexpected death in epilepsy (SUDEP) was established after successful resuscitation. Cases had a higher prevalence of congenital/inherited heart disease (17% vs 1%, p 0.002), and experienced VT/VF at younger age (57 vs 64 years, p 0.023) than VT/VF controls. VT/VF in cases occurred more frequently at/near home (89% vs 58%, p 0.009), and was less frequently witnessed (72% vs 89%, p 0.048) than in VT/VF controls. Cases more frequently had clinically relevant heart disease (50% vs 15%, p 0.005) and intellectual disability (28% vs 1%, p < 0.001) than epilepsy controls. Conclusion: Cardiovascular disease rather than epilepsy characteristics is the main determinant of VT/VF in people with epilepsy in the community. SCA and SUDEP are partially overlapping disease entities.

Original languageEnglish
Pages (from-to)212-218
Number of pages7
Issue number3
Publication statusPublished - 21 Jul 2015

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