PM and Syncope/Seizures? Ictal Asystole

Hi all, I'll get right to it - I started having syncope episodes last May - otherwise a healthy, fit 24 year old guy. Had all sorts of tests done and nothing was showing anythting out of the ordinary cardiac-wise. Finally had a Zio monitor on that caught 2 episodes and they saw my heart stopped for 20sec both times - got a PM placed the next week. That was in August and things have been a lot better since, but still have had 'dizzy spells' every couple of weeks. Not very fun, but they always would pass after a minute or two.

On Thursday last week, I was having one of those days and was feeling a little off. I was sitting at my desk at work and then next thing I knew, I was being taken out of an ambulance into the ER after having what was described by coworkers as a very serious tonic-clonic seizure, no memory of anything in between (it was probably at least 30-45min). 

I've had a few tests this week (EEG and MRI) and have a neurologist appt scheduled for next, but don't have much more info as of yet. A close family friend that's a doctor sent over this article about Ictal Asystole saying she thought it really checked all of the boxes, which I feel that it does. How she explained it to me in laymen's terms is that first, these 'episodes/off days' may have been small focal seizures all along. For whatever reason, they were sending me into cardiac arrest (hence the 20 second heart pause, but nothing else wrong), but once I was in cardiac arrest, it stopped the seizure in it's tracks so that when I regained conciousness it just seemed like I fainted. However, now that I have a PM it prevents me from going into cardiac arrest, which ironically allows the seizure to continue to progress, with this last one developing into a full generalized seizure. 

No idea if this is actully what's happeneing or not, but it sure seems like it's worth looking into more. I haven't seen anything about this on the site (this is a very rare condition, supposedly only about 0.5% of all epilepsy patients) but I'm curious if anyone else has had an experience similar to this? Just hoping to collect as much information as I possibly can, I'm tired of having no idea what's wrong with me.



Sorta - Very Interesting

by AgentX86 - 2020-01-29 16:01:43

I had near syncope events, which they found to be asystoles though the longest recorded was 8-seconds. That was two years ago. I'd had AF/AFL for 10 years before.

Last fall I had a tonic-clonic seizure. My Neurologist believes (guesses) that it was caused by micro-infarcts caused by mini-strokes from the Afib, before I was on anticoagulants. Who knows, this story might fit better.


Cardiac arrest associated with convulsions.

by Selwyn - 2020-01-30 08:23:46


Hi there, sorry to hear of your health problems, and at such a young age. You seem to be very stoical /brave. Thank you for the posting and welcome to The Club.

Exact diagnosis is always difficult.

It is possible to have a clonic type of seizure associated with fainting (vaso-vagal attack) whilst in the upright position.  eg. whilst seated. Vasovagal faints are usually associated with symptoms of light-headedness /dizziness prior to blackout. Convulsions come without warning symptoms. 

It has long been known that there is a sudden death mortality associated with epilepsy. Very sadly, I have seen a number of cases ( as a forensic doctor). 

( see )

I think your doctor friend may well be right. I am suprised that given your history of blackouts, epileptic type activity was not initially  excluded along with the cardiac issues.  

Thank goodness you now have a pacemaker. We are the lucky ones!

You will need further neurological investigations. If you are actually having seizures, good control is essential, and this is done by taking regular medication. 

And, thank you for the https reference - it is so helpful to have medical site information. I have always tried to provide this for folk myself so that they can do further reading.

Do let us know the outcome of your neurology and I wish you the very best health outcome possible. 


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