HEART CONDUCTION AND RHYTHM DISORDERS IN IKTAL EPILEPSY PERIOD: THE PREVALENCE AND PREDICTORS

Aim. To assess the characteristics and prevalence of cardiac rhythm disorders in epilepsy patients during the iktal period, by long term ECG monitoring.Material and methods. To the study, 79 patients included, age 18 to 51 y. o. with confirmed diagnosis of focal epilepsy with continuing attacks regardless the antiepilepsy treatment. For rhythm disorder screening, all patients underwent implanting of subcutaneous ECG monitors.Results. Disorders of cardiac rhythm and conduction during the iktal period were found in 88,61% cases. Most prevalent were sinus tachycardia (59,5%, 47 cases), cardiac rhythm and conduction disorders (29%, 23 cases). In 9 cases (11,4%) there were no cardiac rhythm and conduction disorders registered. Also, the probable predictors found, of the disorders of cardiac rhythm in epilepsy patients. Patients gender, type of attacks, frequency, circadian specifics were the markers influencing the rate of iktal cardiac rhythm changes.Conclusion. Sinus tachycardia, rhythm and conduction disorders are registered in most of patients during the iktal period and significantly more common in males, the patients with bilateral tonic and clonic seizures, serial course of the attacks and in the patients with sleep-related seizures. Evaluation of antiepilepsy treatment influence on the prevalence of iktal rhythm and conduction disorders did not reveal significant difference for none of the drug groups. Also, there was no significant differences in comparison of the studied parameters for polyand monotherapy by anticonvulsants

CLINICAL, NEURO-PHYSIOLOGICAL AND NEURO-VISUAL ANALYSIS OF ADULT PATIENTS WITH FOCAL EPILEPSY AND ABNORMALITIES OF CARDIAC RHYTHM AND CONDUCTION IN THE ICTAL PERIOD

Objective. To conduct a survey of adult patients with focal epilepsy and ictal disturbances of cardiac rhythm and conduction, considering the disease classification, anamnesis, clinical, electroencephalographic and neuroimaging data.Materials and methods. We selected 70 patients aged 18 to 51 years old with confirmed diagnoses of focal epilepsy with epileptic seizures persisting at the time of the study on the background of antiepileptic therapy without concomitant cardiac disorders but with confirmed ictal changes in the cardiac rhythm and conduction.Results. Among the examined patients, those with long lasting “structural focal epilepsy”, frequent epileptic attacks, temporal and frontal-temporal epileptogenic foci, taking several antiepileptic drugs, prevailed. Most of the heart rhythm and conduction abnormalities occurred in male patients with serial paroxysms, bilateral tonic-clonic seizures, or sleep seizures.Сonclusion. The timely detection and examination of patients with high risk of ictal arrhythmias is able to prevent disturbances of cardiac rhythm and heart conduction during epileptic seizures, including those with a life-threatening potential