Key result
Focal seizures linked to ~60% higher rates of tachycardia compared to generalized seizures.
Why the study?
Estimates of sinus tachycardia during seizures derive mainly from selected inpatient video-EEG cohorts under controlled conditions, leaving prevalence and determinants in ambulatory settings unclear.
Cohort (n=1,368)
In ambulatory EEG-ECG monitoring, clinically documented sinus tachycardia occurs in about one-third of seizures, which is lower than inpatient estimates, and is associated with longer seizure duration and focal seizures.
Ambulatory data suggest lower real-world tachycardia rates than inpatient estimates; leaves open determinants and monitoring implications.
OBJECTIVE: Sinus tachycardia during seizures is commonly reported in inpatient video-EEG monitoring, often with high prevalence estimates. These data are derived from selected populations under controlled conditions. We examined clinically documented tachycardia prevalence and determinants in a large retrospective ambulatory EEG-ECG cohort. METHODS: Methods: Clinically documented tachycardia during electrographically confirmed seizures was analyzed from finalized ambulatory EEG-ECG reports, with explicitly documented non-sinus tachyarrhythmias identified separately. The analysis was limited to tachycardia documented during seizures and did not include systematic peri-ictal arrhythmia analysis. Sinus tachycardia was defined as heart rate >100 bpm in adults, and age-adjusted thresholds for those <18. Associations with seizure type, duration, and patient-level factors were examined. RESULTS: Reports were analyzed from 1368 patients with 6177 EEG-confirmed seizures. Tachycardia was clinically reported in 2065/6177 (33.4%) of seizures and 769/1368 (56.2%) of patients. Most tachycardia events were sinus/presumed sinus, however 7/2065 seizures with tachycardia were explicitly documented non-sinus tachyarrhythmias. It was more frequent in focal than generalized seizures (39.1% vs 24.4%) and was associated with longer seizure duration (median 61 s vs 18 s). Younger age and female sex were associated with tachycardia, though the age effect was modest. Medication effects were not robust after correction. Marked within-patient variability was observed: 30.5% had tachycardia in all seizures, 25.7% in some, and 43.8% in none. CONCLUSIONS: In ambulatory monitoring, clinically documented sinus tachycardia occurs in one third of seizures, substantially lower than some inpatient estimates. Clinically documented ictal sinus tachycardia is associated with seizure duration, is more common in focal seizures, and demonstrates marked variability within individuals.
No takes yet. Share an insight, caveat, or question.
Cook et al. (2026) conducted a cohort in Seizures (n=1,368). Focal seizures vs. Generalized seizures was evaluated on Clinically documented tachycardia during seizures. Clinically documented tachycardia occurred in 33.4% of seizures during ambulatory monitoring, and was more frequent in focal compared to generalized seizures (39.1% vs 24.4%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: