Heart rhythm disturbance in epilepsy

Among some people with epilepsy, potentially fatal heart rhythm abnormalities can occur during a seizure. It is possible that these dangerous rhythms might be prevented with permanently implanted pacemakers.Researchers from the University College London, UK, studied 19 patients with a history of seizures, all of whom had been considered for surgical treatment of their epilepsy and were considered to be at high-risk for sudden unexpected death. The participants were fitted with implantable loop recorders, which can monitor the heart's electrical activity for up to 18 months. Over a period of 24 months, 377 seizures occurred, and all 19 patients experienced a racing heart rate during some seizures. A very slow heart rate occurred during eight seizures in seven participants in the study. Four of these patients who had a severely reduced heart rate or even periods with no heartbeats, had a permanent pacemaker inserted. The device takes over control of the heart rate if it drops too much.
The above study provides hope that some cases of sudden unexplained death in people with epilepsy might be preventable. But as this might lead to overuse of loop recorders and excessive anxiety about a condition that might or might not be preventable, further research is needed before evaluation for a pacemaker becomes routine for people with epilepsy.

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