Can seizures cause cardiac arrhythmias?

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Seizures can affect the heart rate, which can lead to arrhythmias. Some develop during different phases of the seizure, such as the ictal and postictal phases:

• Ictal: This is the middle phase of the seizure, from when the first symptom begins, and the seizure activity ends.
• Postictal: This is the end phase of the seizure. This is when the seizure begins to subside and lasts between 5–30 minutes.

Many different types of arrhythmia have associations with seizures.

Authors of a 2018 case presentation note that the most common type of arrhythmia associated with seizures is ictal tachycardia, which refers to a faster-than-normal heartbeat.

A 2019 article notes that the arrhythmias caused by seizures include:

• ictal asystole: the heart rate stops, and can lead to a sudden unexpected death
• ictal bradycardia: a slower-than-normal heart rate
• postictal atrial flutter: the upper chambers of the heart beat too quickly
• postictal atrial fibrillation: an irregular heart rhythm affecting the upper chambers of the heart
• postictal ventricular tachycardia: the lower chambers of the heart beat too quickly
• postictal ventricular fibrillation: an irregular heart rhythm affecting the lower chambers of the heart

Healthcare professionals remain uncertain about why this occurs. However, they theorize that electrical activity within the brain during a seizure may be a contributing factor.

When a person has a seizure, there are unusual patterns of electrical activity within the brain. This can cause a range of physical effects, including convulsions. In some cases, the electrical activity in the brain may contribute to arrhythmia.

What increases the risk of arrhythmia if a person has seizures?

According to a 2017 study, the following people are more likely to experience arrhythmias after a seizure:

• males
• those ages 65–84 years
• having certain health conditions, such as:
  • cardiovascular disease
  • lung disease
  • neurological problems
  • kidney problems
  • iron deficiency
  • diabetes

Healthcare professionals are unsure whether arrhythmias can cause seizures.

A 2016 case report discusses an individual whose arrhythmia induced a convulsive syncope. A convulsive syncope occurs when someone loses consciousness and has convulsions at the same time.

Although convulsive syncope can look like seizures, they are different conditions.

Because doctors commonly misdiagnose convulsive syncope as seizures, it is difficult to know how often a cardiac arrhythmia might have caused a seizure.

A 2021 paper notes evidence that antiepileptic drugs can cause arrhythmias. However, these are rarely serious or life threatening.

Can epilepsy medications cause other heart problems?

Doctors can treat epilepsy with antiepileptic drugs.

The authors of the 2021 paper state that some older studies suggested a correlation between antiepileptic drug use and a greater risk of certain cardiovascular problems, such as heart attack.

The paper’s authors found similar evidence of this correlation in the group of 10,241 people with epilepsy.

However, the authors also state that this correlation may partly arise from factors besides antiepileptic drug use.

There are no established medical guidelines for how best to treat seizure-induced arrhythmias. However, some people may require a cardiac pacemaker.

According to the American Heart Association (AHA), treatment for arrhythmia may involve:

• taking medications that help to regulate heart rate
• heart rate monitoring
• talking with healthcare professionals about any pharmaceutical or recreational drug use

These steps can help to prevent serious complications of arrhythmia.

According to the 2017 study above, people who have seizures have a higher mortality rate if they also have an arrhythmia. For instance, the study notes a risk of sudden cardiac arrest of around 1.4%.

The study notes that people are around 4.9 times more likely to die if they also have an arrhythmia. However, these statistics are widely variable based on the particular arrhythmia.

Males are more likely to have life threatening arrhythmias following seizures.

Scientists do not know whether standard preventive steps could be effective.

However, to reduce the risk of arrhythmias such as atrial fibrillation, a person may benefit from:

• maintaining healthy cholesterol levels, blood glucose levels, and blood pressure
• quitting smoking, if applicable
• following an exercise program
• eating a healthy diet
• having a healthy body mass index

There is no specific medical guidance on how to prevent arrhythmias in people with seizures.

The AHA states that when an arrhythmia is more recent, an individual may experience:

• heart palpitations
• feeling like their heart is skipping beats
• a fluttering feeling in the chest or neck

As the arrhythmia develops, it may cause the following symptoms:

• weakness
• fatigue
• light-headedness
• dizziness
• fainting
• shortness of breath
• sweating
• anxiety
• a rapid, pounding heartbeat
• pain or pressure in the chest

These symptoms can indicate a more serious arrhythmia.

Anyone with symptoms of arrhythmia should contact a doctor.

Additionally, an individual should receive emergency medical care if they collapse. This possible sign of arrhythmia can mean that the arrhythmia has induced a heart attack.

Individuals should also receive emergency medical care if they have had a seizure.

Arrhythmias can follow a seizure. The reason for this is still uncertain. However, seizures arise from abnormal electrical activity in the brain, which could somehow contribute to arrhythmias.

Several factors increase the risk of arrhythmias following seizures. These include being male, between the ages of 65 and 84, and having certain health conditions, such as cardiovascular disease and kidney problems.

Healthcare professionals do not know whether arrhythmias can cause seizures. There have been cases of arrhythmia-induced convulsive syncope. However, although convulsive syncope may resemble seizures, they are distinct conditions.