Key result
Delayed detection of seizure-induced Takotsubo syndrome was associated with a higher frequency of negative T-waves compared to immediate detection (64% vs. 13%, p = .0009).
Why the study?
It was unknown whether patients with immediate and delayed detection of seizure-induced Takotsubo syndrome differ in clinical and electrocardiographic findings.
Do clinical and electrocardiographic findings differ between patients with immediate versus delayed detection of seizure-induced Takotsubo syndrome?
Systematic Review (n=48)
Do clinical and electrocardiographic findings differ between patients with immediate versus delayed detection of seizure-induced Takotsubo syndrome?
Delayed detection of seizure-induced Takotsubo syndrome is associated with a higher frequency of negative T-waves, emphasizing the need for routine postictal ECG and troponin screening.
Answers are grounded in this paper and cite their sources.
Negative T-waves may signal delayed detection after seizures; hypothesis-generating for postictal ECG screening protocols.
Takotsubo syndrome(TTS) is often preceded by emotional or physical stress. Epileptic seizures are described in >100 cases. It is unknown whether patients with immediate and delayed detection of seizure-induced TTS differ. We screened the literature and compared clinical and electrocardiographic (ECG) findings. In 48 cases with seizure-associated TTS, the time between seizure and TTS-detection was reported. Troponin levels were elevated in 37/40. ECG abnormalities were negative T-waves(40%), ST-elevations(33%) and ventricular fibrillation/flutter(10%). Immediate detection was reported in 23 patients, in the remaining 25 patients, TTS was detected 5-288 h postictally. Patients did not differ in gender, age or symptoms. Negative T-waves were more frequent in patients with delayed detection(64 vs. 13%, p = .0009), whereas ECG-abnormalities suggesting acute myocardial infarction tended to be more prevalent in patients with immediate detection. Due to lack of typical symptoms, seizure-induced TTS can be overlooked. Postictally, an ECG should be recorded and troponin levels measured. New T-wave inversions might indicate seizure-induced TTS.
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Stöllberger et al. (2018) conducted a systematic review in Seizure-associated Takotsubo syndrome (n=48). Delayed detection vs. Immediate detection was evaluated on Negative T-waves on ECG (p=.0009). Delayed detection of seizure-induced Takotsubo syndrome was associated with a higher frequency of negative T-waves compared to immediate detection (64% vs. 13%, p = .0009).
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