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Yassin A, El-Salem K, Khassawneh BY, Al-Mistarehi AH, Jarrah M, Zein Alaabdin AM, Abumurad SK, Qasaimeh MG, Bashayreh SY, Kofahi RM, Alhayk KA, Alshorafat D, Al Qawasmeh M. Diagnostic value of electrocardiogram during routine electroencephalogram. Seizure 2021; 89:19-23. [PMID: 33971558 DOI: 10.1016/j.seizure.2021.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/17/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION A single-lead electrocardiogram (EKG) is routinely recorded with electroencephalogram (EEG). This study investigates the frequency and types of EKG abnormalities during routine EEG. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Ahmed Yassin
- Assistant Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan..
| | - Khalid El-Salem
- Full Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Basheer Y Khassawneh
- Full Professor; Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamad Jarrah
- Associate Professor; Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Anas M Zein Alaabdin
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sumayyah K Abumurad
- Specialist of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad G Qasaimeh
- Specialist of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Salma Y Bashayreh
- Assistant Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Raid M Kofahi
- Assistant Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Kefah A Alhayk
- Assistant Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Duha Alshorafat
- Assistant Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Majdi Al Qawasmeh
- Assistant Professor of Neurology; Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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