The brain-heart connection: Value of concurrent ECG and EEG recordings in epilepsy management.

Concurrent electrocardiogram (ECG) and electroencephalogram (EEG) recording both ictally and interictally has significant value in the comprehensive management of epilepsy. This review highlights the diagnostic utility of simultaneous ECG and EEG monitoring in differentiating between epileptic and cardiac events, detecting cardiac abnormalities, and identifying autonomic dysfunction. The critical role of this combined approach to defining the mechanisms underlying cardiac morbidity and sudden cardiac death in patients with epilepsy and in guiding therapeutic interventions is underscored. The "Epileptic Heart Syndrome" is examined, illustrating how chronic epilepsy can adversely affect cardiac structure and function, leading to increased risk for interictal cardiac arrhythmias, morbidities, and mortality. The findings emphasize the need for standardized protocols for routine concurrent ECG and EEG recording in epilepsy monitoring units both ictally and interictally to ensure comprehensive patient care, improve diagnostic accuracy, and potentially reduce epilepsy-related morbidity and mortality. Future research directions are proposed to address existing gaps and to advance the technology and methodology for concurrent monitoring including wearable and computer-based monitoring systems.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jeremy Slater is CMO of Stratus, Inc., and reports financial support and administrative support provided by Stratus including employment, equity or stocks, and non-financial support. He owns stock in Zeto, Inc., a manufacturer of a dry electrode EEG headset. Selim Benbadis is National Medical Director of Stratus. Richard Verrier is a member of the Medical Advisory Board of Stratus and has received lecture honoraria from Stratus and from UCB.
(© 2024 The Authors. Published by Elsevier Inc.)