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.
Keywords: automated external defibrillator (aed); epilepsy; postictal arrhythmia; seizure; sudden cardiac arrest; vagus nerve stimulator; ventricular fibrillation.
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