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
研究背景：从临床实践角度而言，同步双导联心电图（electrocardiogram, ECG）记录在常规脑电图（electroencephalogram, EEG）检查中的重要性已被多次报道。
研究目的：本研究旨在探究接受常规EEG检查的患者样本中，同步双导联ECG检测到的心律失常发生率；尤为关键的是，本研究拟通过更为资深的同步ECG解读方案，评估研究结果的潜在拓展空间。
研究方法：对2016年1月至3月期间完成的常规EEG检查中同步采集的双导联ECG记录，由心脏科专科医师进行回顾性分析。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EEG报告进行检索筛查，以评估神经科医师的解读结果。
研究结果：本研究共纳入478份常规EEG记录。患者平均年龄为42.8±19.8岁，年龄范围16~95岁，性别比为264/214（女/男）。经心脏科专科医师评估后，80例（17%）患者的同步ECG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，EEG报告中提及心律失常相关关键词的比例为9.4%（共45份），其中具体表述包括心动过速（3.3%）、心律失常（2.5%）、心动过缓（2.1%）及期前收缩（1.5%）。
研究结论：经心脏科专科医师解读后，常规EEG检查期间同步记录的ECG中，心律失常检出率较高。然而，EEG报告的关键词检索结果显示心律失常检出率相对偏低。上述结果提示，常规EEG检查期间ECG异常的检出率或可得到进一步提升。