# Sudden Cardiac Arrest With Ventricular Fibrillation in a Patient With Epilepsy and a Vagus Nerve Stimulator

## TL;DR

A woman with epilepsy and a vagus nerve stimulator experienced sudden cardiac arrest after a seizure, highlighting the complex link between epilepsy and heart rhythm issues.

## Contribution

This case report explores the rare but significant interaction between epilepsy, vagus nerve stimulation, and sudden cardiac arrest.

## Key findings

- The patient experienced out-of-hospital cardiac arrest following a witnessed seizure.
- Successful defibrillation restored circulation, but initial tests showed no clear cause.
- The case underscores the need for integrated neurological and cardiac care in epilepsy patients.

## Abstract

Sudden cardiac arrest (SCA) in patients with epilepsy, particularly those with vagus nerve stimulators (VNS), is rare but clinically significant. We report the case of a 36-year-old woman with known epilepsy and a VNS implant who suffered an out-of-hospital cardiac arrest (OHCA) following a witnessed tonic-clonic seizure. Emergency services identified ventricular fibrillation (VF), and successful defibrillation led to the return of spontaneous circulation (ROSC). Initial investigations, including imaging and laboratory studies, were unremarkable. A multidisciplinary evaluation involving neurology and cardiology was undertaken to explore potential seizure-related cardiac mechanisms and the possible role of the VNS device. This case highlights the complex interplay between epilepsy, autonomic dysfunction, and arrhythmia, emphasising the importance of integrated care and further research into neurocardiac interactions in patients with epilepsy.