Determining factors of electrocardiographic abnormalities in patients with epilepsy: A case-control study

Sousa, Jorge Murilo Barbosa De; Fialho, Guilherme Loureiro; Wolf, Peter; Walz, Roger; Lin, Kátia

doi:10.1016/j.eplepsyres.2016.12.011

Cited by 30 publications

(17 citation statements)

References 46 publications

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“…The frequency of early repolarization pattern did not differ between the alive and deceased patient groups ( p > 0.999), it was found only in 1.6% of patients; it is also substantially less frequently than in other studies, where such a finding was reported in 9.7–34% of patients [ 23 , 69 , 78 ]. Abnormal early repolarization has recently been found to be more prevalent in epilepsy patients than in controls.…”

Section: Discussioncontrasting

confidence: 52%

“…One study provides a detailed description of ECG abnormalities, including atrial enlargement, ventricular hypertrophy, bundle-branch blocks, fascicular blocks, AV block, and pathologic Q and T waves. A more prolonged P-wave and PR interval, longer QT intervals, pathologic QT dispersion, and left atrial overload were found in epilepsy patients compared to the control population in this study [ 69 ]. A compilation of interictal parameters from several ECG studies has been performed elsewhere [ 69 , 70 ].…”

Section: Discussionmentioning

confidence: 78%

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Electrocardiographic Abnormalities and Mortality in Epilepsy Patients

et al. 2021

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Background and Objectives: People with epilepsy (PWE) have a 2–3 times higher mortality rate than the general population. Sudden unexpected death in epilepsy (SUDEP) comprises a significant proportion of premature deaths, whereas sudden cardiac death (SCD) is among the leading causes of sudden death in the general population. Cardiac pathologies are significantly more prevalent in PWE. Whether electrocardiographic (ECG) parameters are associated with remote death in PWE has yet to be elucidated. The study objective was to assess whether interictal ECG parameters are associated with mortality in the long-term. Materials and Methods: The study involved 471 epilepsy patients who were hospitalized after a bilateral tonic-clonic seizure(s). ECG parameters were obtained on the day of hospitalization (heart rate, PQ interval, QRS complex, QT interval, heart rate corrected QT interval (QTc), ST segment and T wave changes), as well as reported ECG abnormalities. Mortality data were obtained from the Latvian National Cause-of-Death database 3–11, mean 7.0 years after hospitalization. The association between the ECG parameters and the long-term clinical outcome were examined. Results: At the time of assessment, 75.4% of patients were alive and 24.6% were deceased. Short QTc interval (odds ratio (OR) 4.780; 95% confidence interval (CI) 1.668–13.698; p = 0.004) was associated with a remote death. After the exclusion of known comorbidities with high mortality rates, short QTc (OR 4.631) and ECG signs of left ventricular hypertrophy (OR 5.009) were associated with a remote death. Conclusions: The association between routine 12-lead rest ECG parameters—short QTc interval and a pattern of left ventricular hypertrophy—and remote death in epilepsy patients was found. To the best of our knowledge, this is the first study to associate rest ECG parameters with remote death in an epileptic population.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 78%

Electrocardiographic Abnormalities and Mortality in Epilepsy Patients

et al. 2021

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“…Pd represents the homogeneity of inter-and intra-atrial conduction [18]. Souza et al observed prolonged P-wave in patients with epilepsy than in controls [19]. In epilepsy patients, it was shown that cardiac repolarization abnormalities may cause SUDEP due to ventricular tachyarrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Cardiac Repolarization Indices in Epilepsy Patients Treated with Carbamazepine and Valproic Acid

Asoğlu

Özdemir²,

Aladağ

et al. 2020

Medicina

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Background and Objectives: Epilepsy patients have a higher risk of sudden unexplained death compared to the rest of the population. Cardiac repolarization abnormalities might be seen in epilepsy during interictal periods. We aimed to evaluate the changes in electrocardiography (ECG) parameters in generalized tonic-clonic seizure patients treated with carbamazepine or valproic acid (VPA) drug. Materials and Methods: A totally of 129 subjects (66 epilepsy patients, 63 healthy subjects) were enrolled in the study. Of the patients, 36 were on carbamazepine and 30 were on VPA. There were 12-lead ECGs obtained from all participants. RR interval (time between consecutive R peaks), QT interval (defines the period of ventricular repolarization), corrected QT (QT interval corrected for heart rate; QTc), QTc-maximum (QTc-max), QTc-minimum (QTc-min), QTc dispersion (QTcd), P (atrial depolarization )-maximum (P-max), P-minimum (P-min) and P dispersion (Pd) were measured. Results: QTd (QT dispersion), QTcd, and Pd values were significantly higher in the patients compared to the controls (p < 0.01). QTcd, Pd, and P-max values were statistically higher in male patients compared to healthy male controls. QTcd values were significantly higher in female patients using carbamazepine compared to the female patients on VPA and healthy controls (p = 0.01). Male patients using VPA had significantly higher QTcd values against the male population in carbamazepine and control groups. Conclusions: This study demonstrated that QTd, QTcd, and Pd values were significantly higher in epilepsy patients than in healthy controls. In addition, female patients using carbamazepine and male patients using VPA were prone to ventricular arrhythmia compared to the control group.

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“…Sousa et al 32 reported that patients with epilepsy had significantly longer P wave, PR interval, QTc interval, and pathologic QTd. Surges et al 33 found those with refractory epilepsy had abnormal cardiac repolarization at rest, during or after seizures.…”

Section: Journal Of Pediatric Epilepsymentioning

confidence: 99%

Electrocardiography Parameters Changes in Epilepsy and Febrile Convulsion Children Compared with Controls

Noori

Teimouri

Khajeh

2020

Journal of Pediatric Epilepsy

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AbstractEpilepsy and febrile convulsion are the most common neurological diseases with significant effect on cardiac functions. The study aimed to evaluate electrocardiography parameters alterations in epilepsy and febrile convulsion children compared with controls. In this comparison study, 270 children analyzed who shared equally in epilepsy, febrile convulsion, and healthy that aged from 0.5 to 5 years. The participants were collected from Ali ibn Abi Talib Hospital of Zahedan, Iran. Epilepsy confirmed based on definition of having at least two unprovoked seizures in 24 hours. Febrile convulsion was confirmed based on its definition by the International League against Epilepsy. Healthy children selected from those referred to the hospital with fever and without any underline diseases. Electrocardiography was performed by a pediatric cardiologist. Data were analyzed using SPSS 19 with p < 0.05 significant level. Heart rate was higher in epilepsy (129.64 ± 27.63) compared with control (108.78 ± 26.01) and febrile convulsion (125.79 ± 25.38; X 2 = 28.701, p < 0.001). S wave in lead V1 was higher in controls (0.72 ± 0.36) compared with epilepsy (0.58 ± 0.45) and febrile convulsion (0.58 ± 0.36). QT dispersion and QTc dispersion levels were higher in epilepsy than febrile convulsion children that both were higher than controls. Concluded that R in aVL, LV mass (LVM), QT dispersion, and QTc dispersion were higher significantly in epilepsy compared with febrile convulsion children. To maintain a good strategic treatment in patients with epilepsy and febrile convulsion, there is a need to assess alternations in ECG parameters, especially QT interval changes that lead to better comprehensive autonomic changes.

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Determining factors of electrocardiographic abnormalities in patients with epilepsy: A case-control study

Cited by 30 publications

References 46 publications

Electrocardiographic Abnormalities and Mortality in Epilepsy Patients

Electrocardiographic Abnormalities and Mortality in Epilepsy Patients

Evaluation of Cardiac Repolarization Indices in Epilepsy Patients Treated with Carbamazepine and Valproic Acid

Electrocardiography Parameters Changes in Epilepsy and Febrile Convulsion Children Compared with Controls

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