Abstract Details

Title Cardiology Perspective on Seizure Related Bradyarrhythmias and SUDEP: A Survey Study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-008

Objective To determine the current knowledge and experience with seizure related bradyarrhythmias and SUDEP amongst cardiologists.

Background Autonomic changes related to seizures are common. They can occur during the ictal or post ictal period. Two concerning arrhythmias to neurologists and cardiologists in these periods are significant bradycardia and asystole. Post ictal asystole has been investigated as a potential mechanism for sudden unexpected death in epilepsy (SUDEP).

Design/Methods A 27 question survey was designed to assess demographics, personal experience, and training involving SUDEP and seizure related bradycardia and asystole. Following IRB approval, a list of US cardiology fellowships was constructed using the AAMC public website. Surveys were distributed by email to all programs whose program director or coordinator’s email was readily available on their website. They were asked to forward the survey to both cardiology fellows and practicing cardiologists. The survey was also distributed locally.

Results 51 completed surveys were received: 23 from fellows and 28 from practicing cardiologists. 50/51 were from academic centers. 47% answered they had been consulted for ictal bradycardia or asystole. Nine and 14 recommended treatment for ictal bradycardia or ictal asystole, respectively. 37% answered they had been consulted for post-ictal bradycardia or asystole. Eight recommended treatment for post-ictal bradycardia or asystole, respectively. Treatment recommendations included medications and/or pacemaker. None reported having a substantial knowledge of SUDEP. 63% and 35% reported no knowledge or little knowledge of SUDEP, respectively. None reported formal teaching regarding SUDEP with only one reporting formal teaching about seizure related arrhythmias.

Conclusions Our results indicate ictal bradyarrhythmias are less commonly known to cardiologists, with SUDEP awareness being far less. Formal education on these two topics could prove beneficial in the care of epilepsy patients.

Authors/Disclosures
Mark Farrenburg, MD (Cape Neurology Specialists) PRESENTER	Dr. Farrenburg has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Patrick Landazuri, MD, FAAN (University of Kansas - Department of Neurology - Comprehensive Epilepsy Center)	Dr. Landazuri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuropace. Dr. Landazuri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuropace. Dr. Landazuri has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Federal Public Defender - District of Kansas. Dr. Landazuri has received publishing royalties from a publication relating to health care.

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