title: The treatment of ictal asystole with cardiac pacing.
abstract: Ictal asystole may contribute to seizure-related injury and mortality. The purpose of this study was to evaluate the effect of cardiac pacing on seizure-related injury rates in ictal asystole patients. A survey was conducted to determine seizure-related fall rate and other morbidity in all seven patients with ictal asystole who underwent cardiac pacing at our institution between 1990 and 2004. The rate of seizure-related falls and other morbidities before and after pacing were compared using the Wilcoxon rank-sum test. The mean fall rate was 3.28 falls/month pre-pacemaker implantation. Following pacemaker implantation, this was reduced to 0.005 falls/month (p = 0.001). Seizure-related fractures and motor vehicle accidents were also reduced following cardiac pacing. These findings may have implications in mitigating the potential morbidity associated with ictal asystole.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. moseley.brian@mayo.edu
authors.forename: Brian D
authors.initials: BD
authors.lastname: Moseley
authors.forename: Gena R
authors.initials: GR
authors.lastname: Ghearing
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Munger
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Britton
mesh_terms: D000058:Accidental Falls / Q000401:mortality / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004827:Epilepsy / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D055815:Young Adult