The Relationship Between Cardiac Vulnerability and Restitution Properties of the Ventricular Activation Recovery Interval

Yamashita, Soichiro; Yoshida, Akihiro; Fukuzawa, Koji; Nakanishi, Teruyuki; Matsumoto, Akinori; Konishi, Hirokazu; Ichibori, Hirotoshi; Hyogo, Kiyohiro; Hirata, Ken–ichi

doi:10.1111/jce.12672

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Epileptic patients are at a higher risk of cardiac arrhythmias as there is a relationship between the ventricular recovery and the vulnerability of arrhythmias. Early recognition of cardiac changes would help in predicting seizures and better individualized management protocols [11] .…”

Section: Discussionmentioning

confidence: 99%

Effect of Intractable Epilepsy on the Physiological Cardiac Performance Parameters and the Serum Levels of Cardiac Fatty Acid Binding Protein in Pediatrics

El-Tawab¹,

El-Hamid²,

Awad³

2018

The Medical Journal of Cairo University

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Background: Multiple cardiac changes and various abnormalities have been linked to epileptic fits. The assessment of cardiac changes and serum biomarkers level are commonly accepted methods to evaluate autonomic disturbances during epileptic fits which is very closely associated with some cardiovascular events especially the sudden unexpected cardiac death. Aim of Study: To evaluate ictal and inter-ictal cardiac changes and plasma levels of heart type fatty acid binding protein (H-FABP) in pediatric patients with treatment resistant epilepsy. Patients and Methods: 32 seizure attacks were recorded in 23 children with intractable seizures. Simultaneous Holter-ECG and video-EEG recordings were done with evaluation of changes in Heart Rate (HR), parameters of Heart Rate Variability (HRV), as well as serum levels of H-FABP as a marker of myocardial ischemia in the ictal and inter-ictal periods and compared with a control group. Results: The recorded HR changes included Ictal Tachycardia (IT) (96.87%), Ictal Bradycardia (IB) (3.13%), Premature Atrial Contractions (PAC) (18.75%) and Premature Ventricular Contractions (PVC) (28.13%) in the first postictal hour. Significant HR increase was observed in the preictal hour and ictal values compared to basal values and remained high 2 hours post-ictally. Basal HR and serum levels of the H-FABP protein were significantly higher while time domain HRV parameters were significantly lower in the patients compared to controls. Conclusion: Significant cardiac changes may occur even before the seizure onset in cases with intractable epilepsy. The increased levels of H-FABP may indicate the presence

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Section: Discussionmentioning

confidence: 99%

Effect of Intractable Epilepsy on the Physiological Cardiac Performance Parameters and the Serum Levels of Cardiac Fatty Acid Binding Protein in Pediatrics

El-Tawab¹,

El-Hamid²,

Awad³

2018

The Medical Journal of Cairo University

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“…This observation indicates that epileptic patients are vulnerable to cardiac arrhythmias as there is a relationship between the ventricular recovery and the vulnerability of arrhythmias. [21] At the time of the study, only one patient had a ratio of QTm/TQm more than one which indicated that this patient at any time will be suffering from serious cardiac arrhythmias. Figure 3b shows that the tachogram (Lorenz plot) of Group II is differed from Group I and the epileptic patients.…”

Section: Discussionmentioning

confidence: 99%

Epileptic Patients are at Risk of Cardiac Arrhythmias: A Novel Approach using QT-nomogram, Tachogram, and Cardiac Restitution Plots

Al-Nimer

Al-Mahdawi

Abdullah

et al. 2017

Journal of Neurosciences in Rural Practice

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Background:Sudden death is reported in patients who had a history of epilepsy and some authors believed that is due to cardiac arrhythmias.Objectives:This study aimed to predict that the epileptic patients are at risk of serious cardiac arrhythmias by QT-nomogram, tachogram (Lorenz), and cardiac restitution plots.Methods:A total number of 71 healthy subjects (Group I) and 64 newly diagnosed epileptic patients (Group II) were recruited from Al-Yarmouk and Baghdad Teaching hospitals in Baghdad from March 2015 to July 2015 and included in this study. The diagnosis of epilepsy achieved clinically, electroencephalograph record and radio-images including computerized tomography and magnetic image resonance. At the time of entry into the study, an electrocardiography (ECG) was done, and the determinants of each ECG record were calculated. The QT-nomogram, tachogram, and cardiac restitution plots were used to identify the patients at risk of cardiac arrhythmias.Results:Significant prolonged corrected QT corrected (QTc) and JT corrected intervals were observed in female compared with male at age ≥50 years while the TQ interval was significantly prolonged in males of Group II. Eight patients of Group II had a significant pathological prolonged QTc interval compared with undetectable finding in Group I. QT nomogram did not disclose significant findings while the plots of Lorenz and restitution steepness disclose that the patients of Group II were vulnerable to cardiac arrhythmias. Abnormal ECG findings were observed in the age extremities (≤18 years and ≥50 years) in Group II compared with Group I.Conclusion:Utilization of QT-nomogram, restitution steepness, and tachogram plots is useful tools for detection subclinical vulnerable epileptic patient with cardiac arrhythmias.

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The Upper Limit of Vulnerability and Critical Points for Defibrillation

Dosdall

Ideker

2021

Cardiac Bioelectric Therapy

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The Relationship Between Cardiac Vulnerability and Restitution Properties of the Ventricular Activation Recovery Interval

Abstract: The maximum slope of the restitution curve was significantly related to the ULV. High defibrillation threshold patients could be detected by the ARI dynamics.

Cited by 4 publications

References 28 publications

Effect of Intractable Epilepsy on the Physiological Cardiac Performance Parameters and the Serum Levels of Cardiac Fatty Acid Binding Protein in Pediatrics

Effect of Intractable Epilepsy on the Physiological Cardiac Performance Parameters and the Serum Levels of Cardiac Fatty Acid Binding Protein in Pediatrics

Epileptic Patients are at Risk of Cardiac Arrhythmias: A Novel Approach using QT-nomogram, Tachogram, and Cardiac Restitution Plots

The Upper Limit of Vulnerability and Critical Points for Defibrillation

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