Abstract
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 language | English |
---|---|
Pages (from-to) | 212-218 |
Number of pages | 7 |
Journal | Neurology |
Volume | 85 |
Issue number | 3 |
DOIs | |
Publication status | Published - 21 Jul 2015 |
Keywords
- Adult
- Aged
- Aged, 80 and over
- Cardiovascular Diseases
- Case-Control Studies
- Cross-Sectional Studies
- Death, Sudden, Cardiac
- Epilepsy
- Female
- Humans
- Male
- Middle Aged
- Prospective Studies
- Registries
- Residence Characteristics
- Risk Factors
- Young Adult