Assistant Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan..
Full Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Seizure. 2021 Jul;89:19-23. doi: 10.1016/j.seizure.2021.04.016. Epub 2021 Apr 25.
A single-lead electrocardiogram (EKG) is routinely recorded with electroencephalogram (EEG). This study investigates the frequency and types of EKG abnormalities during routine EEG.
All routine EEGs (20-60 min) over one year were retrospectively analyzed. A blinded cardiologist interpreted EKG recordings. An epileptologist evaluated EEGs. Demographic data, underlying comorbidities, and indications for the EEG were extracted.
A total of 433 recordings for 365 patients were included. Mean (±SD) age was 46.8 (±21.3) years and 50.4% were females. EKG abnormalities were detected in 28.5% of patients; sinus tachycardia (11%), premature ventricular contractions (7.9%), atrial fibrillation (Afib) (6.3%), sinus bradycardia (2.2%) and premature atrial contractions (1.1%). Afib was more common in females than males (p = 0.020), confirmed in six out of seven patients and discovered in 17 patients. Age (OR: 1.67, 95%CI: 1.05-2.66, p = 0.031), prior diagnosis of epilepsy (OR: 2.25, 95% CI: 1.22 - 4.14, p = 0.009), history of seizure (OR: 1.97, 95%CI: 1.09-3.54, p = 0.024), abnormal EEG (OR: 2.14, 95%CI: 1.25 - 3.66, p = 0.005) and EEGs evaluating seizures/epilepsy (OR: 4.18, 95% CI: 1.32 - 13.21, p = 0.015) or syncope (OR: 3.21, 95% CI: 1.16 - 8.84, p = 0.024) were independently associated with abnormal EKG.
The frequency of EKG abnormalities captured during routine EEGs was high, with Afib being the most significant. Older age, history of epilepsy or seizure, abnormal EEGs, and EEGs evaluating seizures/epilepsy or syncope were significant predictors. These findings suggest neurologists to become more vigilant to EKG recorded during routine EEG as such findings might have diagnostic and therapeutic implications.
常规脑电图（EEG）检查通常会同时记录单导联心电图（EKG）。本研究旨在调查常规 EEG 期间 EKG 异常的频率和类型。
回顾性分析了一年内所有时长为 20-60 分钟的常规 EEG。一位盲法心脏病专家解读 EKG 记录，一位癫痫专家评估 EEG。提取人口统计学数据、潜在合并症和 EEG 指征。
共纳入 365 名患者的 433 次记录。患者的平均（±SD）年龄为 46.8（±21.3）岁，其中 50.4%为女性。28.5%的患者出现 EKG 异常；窦性心动过速（11%）、室性期前收缩（7.9%）、心房颤动（Afib）（6.3%）、窦性心动过缓（2.2%）和房性期前收缩（1.1%）。女性中 Afib 的发生率高于男性（p=0.020），在 7 例患者中的 6 例中得到证实，并在 17 例患者中发现。年龄（OR：1.67，95%CI：1.05-2.66，p=0.031）、癫痫既往诊断（OR：2.25，95%CI：1.22-4.14，p=0.009）、癫痫发作史（OR：1.97，95%CI：1.09-3.54，p=0.024）、异常 EEG（OR：2.14，95%CI：1.25-3.66，p=0.005）和评估癫痫/癫痫发作的 EEG（OR：4.18，95%CI：1.32-13.21，p=0.015）或晕厥的 EEG（OR：3.21，95%CI：1.16-8.84，p=0.024）是 EKG 异常的独立预测因素。
常规 EEG 期间捕捉到的 EKG 异常频率较高，Afib 最为显著。年龄较大、癫痫或癫痫发作史、异常 EEG 以及评估癫痫/癫痫发作或晕厥的 EEG 是重要的预测因素。这些发现提示神经科医生在常规 EEG 期间更要警惕 EKG 的记录，因为这些发现可能具有诊断和治疗意义。
