Mohamed Refik MEDNI
Journal of Emergency Medicine Case Reports - 2026;17(1):34-36
Atrial fibrillation (AF) is a rare but clinically significant post-ictal cardiac arrhythmia that may complicate epileptic seizures and increase the risk of thromboembolic events. New-onset arrhythmias have been described after both focal and generalized tonic-clonic seizures; however, most published reports involve patients without pre-existing epilepsy, and the arrhythmias described are generally tachyarrhythmias. We report the case of a 47-year-old man with established epilepsy, treated with levetiracetam, who presented after a generalized tonic-clonic seizure and subsequently developed new-onset post-ictal atrial fibrillation on continuous cardiac monitoring and repeat electrocardiography. Baseline cardiac investigations, laboratory studies, and inflammatory markers were unremarkable. This case highlights the importance of systematic post-ictal cardiac monitoring, evaluation for reversible triggers, and consideration of anticoagulation with cardiology follow-up in selected patients. Clinicians should be aware of this uncommon association to avoid missed diagnoses and optimize management strategies.
