Monitoring the safety of antiepileptic medication in a child with Brugada syndrome

Gorp, Viola Van; Danschutter, Dirk; Huyghens, Luc; Hachimi-Idrissi, Saı̈d; Sarkozy, Andrea; Chierchia, Gian‐Battista; Henkens, Stefan; Brugada, Pedro

doi:10.1016/j.ijcard.2008.12.156

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…In contrast, to the best of our knowledge there is only one report for Brugada syndrome discussing the safe use of an antiepileptic drug in a child with both epilepsy and Brugada syndrome. 19 However, since we do not know whether this drug is also safe in other patients with both disease entities, this drug is not included as a safe alternative on the website. Likewise, even if a drug were to be reported as 'safe' in patients with Long QT syndrome type-1 or type-2 patients, it would not necessarily mean that it is also safe in Long QT syndrome type-3 or others.…”

Section: Physicianmentioning

confidence: 99%

Safe drug use in long QT syndrome and Brugada syndrome: comparison of website statistics

et al. 2013

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Section: Physicianmentioning

confidence: 99%

Safe drug use in long QT syndrome and Brugada syndrome: comparison of website statistics

et al. 2013

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“…In some patients, this may require hospital admission for intensive ECG monitoring, whereas in other patients monitoring can be performed in an outpatient setting. 10,45,48 Intuitively, one should be more careful in patients with a higher risk profile (eg, in patients with a critical phenotype, previous adverse reactions to drugs, or previous life-threatening arrhythmias) than in patients without an arrhythmia history and a mild or absent phenotype. However, when a high-risk patient is already equipped with an implantable cardioverter defibrillator (ICD) because of his or her high risk, one may more easily consider administration of relatively contraindicated or moderaterisk drugs in an outpatient setting, in the absence of an extremely high-risk phenotype at that moment, because the patient will most probably be protected against sudden death.…”

Section: Sensible Treatment Based On the Cardiac Phenotypementioning

confidence: 99%

Use of Drugs in Long QT Syndrome Type 3 and Brugada Syndrome

Postema

Woosley

2014

Cardiac Electrophysiology Clinics

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“…Myocardial channelopathies such as Brugada syndrome (BrS), long/short QT (LQT/SQT) and early repolarization syndrome (ERS) may cause SD. During the last few years, there has been a growing interest in exploring the possible associations between epilepsy and cardiac arrhythmias [ 10 , 11 ]. Among patients with BrS, there is a higher incidence of SD during sleep as well as SUDEP [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Electrocardiogram Changes in the Postictal Phase of Epileptic Seizure: Results from a Prospective Study

Gigli

Sala

Preda

et al. 2023

JCM

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Background: The brain and heart are strictly linked and the electrical physiologies of these organs share common pathways and genes. Epilepsy patients have a higher prevalence of electrocardiogram (ECG) abnormalities compared to healthy people. Furthermore, the relationship between epilepsy, genetic arrhythmic diseases and sudden death is well known. The association between epilepsy and myocardial channelopathies, although already proposed, has not yet been fully demonstrated. The aim of this prospective observational study is to assess the role of the ECG after a seizure. Materials and Methods: From September 2018 to August 2019, all patients admitted to the emergency department of San Raffaele Hospital with a seizure were enrolled in the study; for each patient, neurological, cardiological and ECG data were collected. The ECG was performed at the time of the admission (post-ictal ECG) and 48 h later (basal ECG) and analyzed by two blinded expert cardiologists looking for abnormalities known to indicate channelopathies or arrhythmic cardiomyopathies. In all patients with abnormal post-ictal ECG, next generation sequencing (NGS) analysis was performed. Results: One hundred and seventeen patients were enrolled (females: 45, median age: 48 ± 12 years). There were 52 abnormal post-ictal ECGs and 28 abnormal basal ECGs. All patients with an abnormal basal ECG also had an abnormal post-ictal ECG. In abnormal post-ictal ECG, a Brugada ECG pattern (BEP) was found in eight patients (of which two had BEP type I) and confirmed in two basal ECGs (of which zero had BEP type I). An abnormal QTc interval was identified in 20 patients (17%), an early repolarization pattern was found in 4 patients (3%) and right precordial abnormalities were found in 5 patients (4%). Any kind modification of post-ictal ECG was significantly more pronounced in comparison with an ECG recorded far from the seizure (p = 0.003). A 10:1 higher prevalence of a BEP of any type (particularly in post-ictal ECG, p = 0.04) was found in our population compared to general population. In three patients with post-ictal ECG alterations diagnostic for myocardial channelopathy (BrS and ERP), not confirmed at basal ECG, a pathogenic gene variant was identified (KCNJ8, PKP2 and TRMP4). Conclusion: The 12-lead ECG after an epileptic seizure may show disease-related alterations otherwise concealed in a population at a higher incidence of sudden death and channelopathies. Post-ictal BEP incidence was higher in cases of nocturnal seizure.

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Monitoring the safety of antiepileptic medication in a child with Brugada syndrome

Cited by 7 publications

References 6 publications

Safe drug use in long QT syndrome and Brugada syndrome: comparison of website statistics

Safe drug use in long QT syndrome and Brugada syndrome: comparison of website statistics

Use of Drugs in Long QT Syndrome Type 3 and Brugada Syndrome

Electrocardiogram Changes in the Postictal Phase of Epileptic Seizure: Results from a Prospective Study

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