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Although epileptic ictal bradycardia (IB) is thought to be relatively rare, it might contribute to sudden unexplained death in epilepsy (SUDEP). The aim of this retrospective study was to estimate IB prevalence in patients with intractable epilepsy. Using 383 consecutive EEG-monitoring studies recorded at one medical center, the authors reviewed data on 1277 seizures occurring in 69 individuals (17 with intracranial recordings). They excluded data from patients with fewer than three interpretable seizures, those lacking clear seizure foci, and those taking arrhythmogenic drugs. The authors defined IB as a heart-rate decline of at least 30 beats per minute (bpm) to fewer than 60 bpm.
In most subjects, monitoring identified ictal tachycardia. …