Features of heart rate disorders in patients with symptomatic seizures at the onset of arterial aneurysm rupture

Symptomatic seizures (SS) frequently occur during the acute phase of subarachnoid hemorrhage (aSAH) due to arterial aneurysm rupture. Changes on electrocardiogram are frequently observed in such patients and may have significance. SS in these patients worsen prognosis and reduce quality of life, highlighting the importance of studying electrophysiological characteristics to optimize diagnosis and improve treatment and rehabilitation approaches. Objective — to investigate the presence of a relationship between electrocardiographic changes and the presence of a SS in the acute phase of aSAH. Materials and methods. We compared the ECG findings from 281 medical records of patients in the acute phase of aSAH aged from 12 to 85. Based on the presence of SS, patients were divided into two groups. Group 1 included patients with SS — 24 (8.5 %) patients. Group 2 included patients without SS — 257 (91,5 %) patients. Results and discussion. Using the multinomial logistic regression method, the dependence of the presence of electrocardiographic changes on the presence of a SS in the acute period of aSAH was studied, and it was found that the presence of a SS in the acute period of aSAH increases the risk of a combination of heart block and extrasystole or atrial fibrillation (p = 0.003). Conversely, patients without SS during the acute phase of aSAH had a higher risk of concurrent bradycardia and heart block (p < 0.001), as well as a combination of bradycardia and extrasystole or atrial fibrillation (p < 0.001). Conclusions. SS in patients at the onset of aSAH significantly increase the risk of сombined cardiac conduction and excitability impairment. Patients without SS at the onset of aSAH had a higher risk of a combination of cardiac automatism and conduction impairment, as well as a cardiac automatism and excitability impairment.