Abstract
Introduction The use of concurrent, single lead electrocardiograph (ECG) recording, when performing a routine electroencephalograph (EEG), has been standard practice for many years. The diagnostic utility of a concurrent ECG is relatively unknown. Previous studies have reported its usefulness in syncope and the detection of newly identified cardiac dysrhythmia but have relied on specialist cardiologist interpretation of the ECG trace. This study expands the understanding of concurrent ECG and provides demographic information regarding the incidence, nature and diagnostic utility of ECG interpretation, during routine EEGs, as evaluated by neurologists.
Methods A single center, retrospective study of routine concurrent EEG and ECG recordings was performed. All routine EEGs, performed over one year, were analysed. Demographic data, underlying comorbidities, reasons for referral and ECG changes were assessed.
Results ECG abnormalities were identified in 147 (13.5%) of concurrent ECG/EEG routine recordings. The presence of ECG abnormalities was significantly associated with the reason for referral, namely being assessed for the evaluation of seizure activity and with increasing patient age. Thirty-eight patients (3.5%) had newly identified ECG abnormalities, of which atrial fibrillation (AF) (12 patients) and sinus bradycardia (9 patients) were the most common. Five patients (0.5%) had a change in their management consequent to the identified ECG changes.
Conclusions These findings support the value of neurologists’ interpretation and need for ongoing concurrent ECGs, during routine EEG recording. , The study raises concern about the requesting clinician’s response to the dentification of newly diagnosed cardiac dysrhythmias.
