Simultaneous electrocardiogram during routine electroencephalogram: arrhythmia rates through the eyes of the cardiologist

ABSTRACT Background: The importance of simultaneous 2-lead electrocardiogram (ECG) recording during routine electroencephalogram (EEG) has been reported several times on clinical grounds. Objective: To investigate arrhythmia rates detected by simultaneous 2-lead ECG in our patient sample undergoing routine EEG. Remarkably, we sought to assess the possible expansion of results with a more experienced interpretation of simultaneous ECG. Methods: Simultaneous 2-lead ECG recordings during routine EEG, performed between January and March, 2016, have been retrospectively analyzed by a cardiology specialist. In addition, EEG reports were screened with the keywords ‘arrhythmia, tachycardia, bradycardia, atrial fibrillation, extrasystole’ to evaluate the neurologist interpretation. Results: Overall, 478 routine EEG recordings were scanned. The mean age of the patients was 42.8±19.8 (16–95), with a sex ratio of 264/214 (F/M). In 80 (17%) patients, findings compatible with arrhythmia were identified on simultaneous ECG after a cardiologist's evaluation. The detected arrhythmia subtypes were: ventricular extrasystole (n=27; 5.6%), supraventricular extrasystole (n=23; 4.8%), tachycardia (n=9; 1.8%), prolonged QRS duration (n=7; 8.7%), atrial fibrillation (n=6; 1.2%), and block (n=6; 1.2%). On the other hand, keywords related to arrhythmia were present in 45 (9.4%) of EEG reports. The reported statements were tachycardia (3.3%), arrhythmia (2.5%), bradycardia (2.1%), and extrasystole (1.5%). Conclusions: A considerably high rate of arrhythmia cases was determined on simultaneous ECG during routine EEG after being interpreted by a cardiologist. However, the screening results of EEG reports revealed relatively low arrhythmia rates. These results suggest that the detection rates of ECG abnormalities during routine EEG may be potentially improved.

摘要
背景：临床层面已有多次相关报道证实，常规脑电图（electroencephalogram, EEG）检查期间同步采集2导联心电图（electrocardiogram, ECG）的重要性。
目的：本研究旨在调查本中心接受常规脑电图检查的患者队列中，同步2导联心电图检测出的心律失常发生率。尤为关键的是，本研究拟通过更具经验的同步心电图解读方式，评估研究结果的潜在拓展价值。
方法：回顾性分析2016年1月至3月期间接受常规脑电图检查时同步采集的2导联心电图记录，解读工作由一名心脏科专科医师完成。此外，以“心律失常、心动过速、心动过缓、心房颤动、期前收缩”为关键词对脑电图报告进行检索筛查，以评估神经科医师的解读情况。
结果：本研究共筛查478份常规脑电图检查记录。患者平均年龄为42.8±19.8岁（年龄范围16~95岁），性别比例为264/214（女/男）。经心脏科专科医师评估后，80例（17%）患者的同步心电图检出与心律失常相符的异常表现。检出的心律失常亚型包括：室性期前收缩（n=27；5.6%）、室上性期前收缩（n=23；4.8%）、心动过速（n=9；1.8%）、QRS波时限延长（n=7；8.7%）、心房颤动（n=6；1.2%）及传导阻滞（n=6；1.2%）。另一方面，45份（9.4%）脑电图报告中出现了与心律失常相关的关键词，其中提及的表述包括心动过速（3.3%）、心律失常（2.5%）、心动过缓（2.1%）及期前收缩（1.5%）。
结论：经心脏科专科医师解读后，常规脑电图检查同期同步心电图中检出心律失常的比例较高。然而，脑电图报告的筛查结果显示心律失常检出率相对较低。上述结果提示，常规脑电图检查期间心电图异常的检出率存在潜在提升空间。