From the Research
Cardioversion and defibrillation do not significantly increase the risk of seizures in most patients. These electrical procedures are designed to restore normal heart rhythm and are generally considered safe from a neurological perspective. While there have been rare case reports of seizures following cardioversion or defibrillation, these events are extremely uncommon and typically occur in patients who have pre-existing risk factors for seizures, such as prior brain injury, stroke, electrolyte abnormalities, or a history of epilepsy 1. The electrical current delivered during these procedures is focused on the heart and is not intended to affect brain tissue. The energy levels used are carefully calibrated to minimize risks, and modern biphasic defibrillators require less energy than older models, further reducing any potential neurological effects.
Some key points to consider:
- The risk of not treating a life-threatening arrhythmia far outweighs the minimal risk of triggering a seizure.
- Patients with a history of seizures should be noted before the procedure, but it is not generally considered a contraindication to necessary cardioversion or defibrillation.
- The procedures are standard of care for certain cardiac conditions and have excellent safety profiles regarding neurological complications.
- Antiarrhythmic drugs may have anticonvulsant effects, but some may also have proconvulsant effects in overdose 2.
- Drug-induced seizures are a concern with certain medications, but cardioversion and defibrillation are not typically associated with this risk 1.
Overall, the benefits of cardioversion and defibrillation in treating life-threatening arrhythmias outweigh the minimal risk of triggering a seizure, and patients should be reassured of the excellent safety profiles of these procedures regarding neurological complications.