No conflict of interest to declare.
Cardiac Arrhythmias and Sudden Unexpected Death in Epilepsy (SUDEP)
Article first published online: 29 NOV 2011
©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 35, Issue 3, pages 363–370, March 2012
How to Cite
VELAGAPUDI, P., TURAGAM, M., LAURENCE, T. and KOCHERIL, A. (2012), Cardiac Arrhythmias and Sudden Unexpected Death in Epilepsy (SUDEP). Pacing and Clinical Electrophysiology, 35: 363–370. doi: 10.1111/j.1540-8159.2011.03276.x
- Issue published online: 5 MAR 2012
- Article first published online: 29 NOV 2011
- Received February 13, 2011; revised September 13, 2011; accepted September 11, 2011.
- cardiac arrhythmias;
- ictal asystole;
- antiepileptic medications
Sudden unexpected death in epilepsy (SUDEP) is a major clinical problem in epilepsy patients in the United States, especially those with chronic, uncontrolled epilepsy. Several pathophysiological events contributing to SUDEP include cardiac arrhythmias, respiratory dysfunction, and dysregulation of systemic or cerebral circulation. There is a significant body of literature suggesting the prominent role of cardiac arrhythmias in the pathogenesis of SUDEP. There is evidence to say that long-standing epilepsy can cause physiological and anatomical autonomic instability resulting in life-threatening arrhythmias. Tachyarrhythmias, bradyarrhythmias, and asystole are commonly seen during ictal, interictal, and postictal phase in epilepsy patients. It is unclear if these rhythm disturbances need attention as some of them may be just benign findings. Evidence regarding prolonged cardiovascular monitoring or the benefit of pacemaker/defibrillator implantation for primary or secondary prevention in epilepsy patients is limited. Awareness regarding pathophysiology, cardiac effects, and management options of SUDEP will become useful in guiding more individualized treatment in the near future. (PACE 2011; 1–8)