Cardiac Repolarization Indices in Epilepsy Patients

Abstract

Objectives: Although epilepsy may be associated with an increased risk for sudden cardiac death, its effects on Q-T intervals has not been established. Methods: To determine whether changes in Q-T interval duration (QT_{max c}, QT_{min c}) and dispersion (QT_{D c}) occur in epileptic patients, we retrospectively studied 40 consecutive patients (age: 36.1 ± 22.2 years) who have had a seizure disorder for 14.0 ± 12.2 years and were seen in the Epilepsy Monitoring Unit, and 60 age-matched non-epileptic controls (age: 38.0 ± 15.6 years). Q-T intervals were calculated from a single 12-lead ECG. Results: QT_{max c} (425 ± 30 vs. 410 ± 36 ms, p = 0.040) and QT_{D c} (63.1 ± 22.4 vs. 31.0 ± 17.2 ms, p = 0.000) were higher, and QT_{min c} (362 ± 36 vs. 379 ± 33 ms, p = 0.040) was lower in epilepsy patients. QT_{max c} was significantly correlated with disease duration (r = –0.35, p = 0.028) before, but not after age correction (r = –0.31, p = 0.053). Neither age nor reported recent seizure frequency was correlated with any repolarization index. Conclusions: QT_{max c} and QT_{D c} are higher in epilepsy patients as compared to control subjects. While Q-T interval appears to be related to disease duration, particularly over the early history of disease, it is unrelated to patient age or recent reported seizure frequency.

Cardiac and Autonomic Mechanisms Contributing to SUDEP

“…Both long and short QT are electrographic predictors of sudden cardiac death (Brotherstone et al, 2010;Neufeld et al, 2009;Seyal et al, 2011;Surges et al, 2010b), which makes it relevant to discuss the possibility of ictal changes of QT interval leading to potentially fatal ventricular arrhythmias and torsades de pointes (Kannankeril et al, 2010;Morita et al, 2008). Abnormal shortening of the QT has been described in association with GTCSs (Seyal et al, 2011;Surges et al, 2010a).…”

Effects of Phenobarbital and Levetiracetam on PR and QTc Intervals in Patients with Post-Stroke Seizure

“…PR-interval prolongation did not correlate with AED treatment, suggesting that this prolongation is intrinsic to epilepsy [7]. Previous reports showed that epilepsy is associated with a QTc-interval prolongation [22,23].…”

Sudden unexpected death in epilepsy: Fatal post-ictal respiratory and arousal mechanisms

“…Peri-ictal cardiac dysfunction is thought to play a role in a subset of SUDEP cases (Brotherstone et al, 2010; Neufeld et al, 2009; Surges et al, 2010a; Surges et al, 2010b; Surges et al, 2010c; Surges and Walker, 2010). Tachycardia is the most common ictal autonomic event.…”