Electrocardiographic Abnormalities and Mortality in Epilepsy Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Materials
2.3. Statistical Analyses
3. Results
3.1. Demographic and Clinical Characteristics
3.2. Epilepsy Characteristics
3.3. ECG Parameter Characteristics
3.4. ECG Parameters in Univariate Analysis
3.5. ECG Parameters in Multivariate Analysis
3.6. Ruling Out Potentially Fatal Known Comorbidities
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Cockerell, O.C.; Hart, Y.M.; Sander, J.W.A.S.; Goodridge, D.M.G.; Shorvon, S.D.; Johnson, A.L. Mortality from Epilepsy: Results from a Prospective Population-Based Study. Lancet 1994, 344, 918–921. [Google Scholar] [CrossRef]
- Cockerell, O.C. The Mortality of Epilepsy. Curr. Opin. Neurol. 1996, 9, 93–96. [Google Scholar] [CrossRef]
- Nashef, L.; Shorvon, S.D. Mortality in Epilepsy. Epilepsia 1997, 38, 1059–1061. [Google Scholar] [CrossRef] [PubMed]
- Gaitatzis, A.; Sander, J.W. The Mortality of Epilepsy Revisited. Epileptic Disord. 2004, 6, 3–13. [Google Scholar]
- Nashef, L. Sudden Unexpected Death in Epilepsy: Terminology and Definitions. Epilepsia 1997, 38, S6–S8. [Google Scholar] [CrossRef]
- Ficker, D.M.; So, E.L.; Shen, W.K.; Annegers, J.F.; O’Brien, P.C.; Cascino, G.D.; Belau, P.G. Population-Based Study of the Incidence of Sudden Unexplained Death in Epilepsy. Neurology 1998, 51, 1270–1274. [Google Scholar] [CrossRef]
- Walczak, T.S.; Leppik, I.E.; D’Amelio, M.; Rarick, J.; So, E.; Ahman, P.; Ruggles, K.; Cascino, G.D.; Annegers, J.F.; Hauser, W.A. Incidence and Risk Factors in Sudden Unexpected Death in Epilepsy: A Prospective Cohort Study. Neurology 2001, 56, 519–525. [Google Scholar] [CrossRef] [PubMed]
- Langan, Y.; Nashef, L.; Sander, J.W. Sudden Unexpected Death in Epilepsy: A Series of Witnessed Deaths. J. Neurol. Neurosurg. Psychiatry 2000, 68, 211–213. [Google Scholar] [CrossRef] [Green Version]
- Ryvlin, P.; Nashef, L.; Lhatoo, S.D.; Bateman, L.M.; Bird, J.; Bleasel, A.; Boon, P.; Crespel, A.; Dworetzky, B.A.; Høgenhaven, H.; et al. Incidence and Mechanisms of Cardiorespiratory Arrests in Epilepsy Monitoring Units (MORTEMUS): A Retrospective Study. Lancet Neurol. 2013, 12, 966–977. [Google Scholar] [CrossRef]
- Lhatoo, S.D.; Nei, M.; Raghavan, M.; Sperling, M.; Zonjy, B.; Lacuey, N.; Devinsky, O. Nonseizure SUDEP: Sudden Unexpected Death in Epilepsy without Preceding Epileptic Seizures. Epilepsia 2016, 57, 1161–1168. [Google Scholar] [CrossRef]
- Dasheiff, R.M.; Dickinson, L.J. Sudden Unexpected Death of Epileptic Patient Due to Cardiac Arrhythmia after Seizure. Arch. Neurol. 1986, 43, 194–196. [Google Scholar] [CrossRef]
- So, E.L.; Sam, M.C.; Lagerlund, T.L. Postictal Central Apnea as a Cause of SUDEP: Evidence from near-SUDEP Incident. Epilepsia 2000, 41, 1494–1497. [Google Scholar] [CrossRef]
- Bird, J.M.; Dembny, K.A.T.; Sandeman, D.; Butler, S. Sudden Unexplained Death in Epilepsy: An Intracranially Monitored Case. Epilepsia 1997, 38, S52–S56. [Google Scholar] [CrossRef]
- Barot, N.; Nei, M. Autonomic Aspects of Sudden Unexpected Death in Epilepsy (SUDEP). Clin. Auton. Res. 2019, 29, 151–160. [Google Scholar] [CrossRef]
- Nashef, L.; Walker, F.; Allen, P.; Sander, J.W.A.S.; Shorvon, S.D.; Fish, D.R. Apnoea and Bradycardia during Epileptic Seizures: Relation to Sudden Death in Epilepsy. J. Neurol. Neurosurg. Psychiatry 1996, 60, 297–300. [Google Scholar] [CrossRef] [Green Version]
- Roth, G.A.; Johnson, C.; Abajobir, A.; Abd-Allah, F.; Abera, S.F.; Abyu, G.; Ahmed, M.; Aksut, B.; Alam, T.; Alam, K.; et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J. Am. Coll. Cardiol. 2017, 70, 1–25. [Google Scholar] [CrossRef]
- Dahlberg, S.T. Gender Difference in the Risk Factors for Sudden Cardiac Death. Cardiology 1990, 77, 31–40. [Google Scholar] [CrossRef]
- Stecker, E.C.; Reinier, K.; Marijon, E.; Narayanan, K.; Teodorescu, C.; Uy-Evanado, A.; Gunson, K.; Jui, J.; Chugh, S.S. Public Health Burden of Sudden Cardiac Death in the United States. Circ. Arrhythmia Electrophysiol. 2014, 7, 212–217. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sotoodehnia, N.; Zivin, A.; Bardy, G.H.; Siscovick, D.S. Reducing Mortality from Sudden Cardiac Death in the Community: Lessons from Epidemiology and Clinical Applications Research. Cardiovasc. Res. 2001, 50, 197–209. [Google Scholar] [CrossRef] [Green Version]
- Adabag, A.S.; Luepker, R.V.; Roger, V.L.; Gersh, B.J. Sudden Cardiac Death: Epidemiology and Risk Factors. Nat. Rev. Cardiol. 2010, 7, 216–225. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Benjamin, E.J.; Muntner, P.; Alonso, A.; Bittencourt, M.S.; Callaway, C.W.; Carson, A.P.; Chamberlain, A.M.; Chang, A.R.; Cheng, S.; Das, S.R.; et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019, 139, e56–e528. [Google Scholar] [CrossRef]
- Bardai, A.; Lamberts, R.J.; Blom, M.T.; Spanjaart, A.M.; Berdowski, J.; van der Staal, S.R.; Brouwer, H.J.; Koster, R.W.; Sander, J.W.; Thijs, R.D.; et al. Epilepsy Is a Risk Factor for Sudden Cardiac Arrest in the General Population. PLoS ONE 2012, 7, e42749. [Google Scholar] [CrossRef]
- Lamberts, R.J.; Blom, M.T.; Novy, J.; Belluzzo, M.; Seldenrijk, A.; Penninx, B.W.; Sander, J.W.; Tan, H.L.; Thijs, R.D. Increased Prevalence of ECG Markers for Sudden Cardiac Arrest in Refractory Epilepsy. J. Neurol. Neurosurg. Psychiatry 2015, 86, 309–313. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Téllez-Zenteno, J.F.; Matijevic, S.; Wiebe, S. Somatic Comorbidity of Epilepsy in the General Population in Canada. Epilepsia 2005, 46, 1955–1962. [Google Scholar] [CrossRef] [PubMed]
- Strine, T.W.; Kobau, R.; Chapman, D.P.; Thurman, D.J.; Price, P.; Balluz, L.S. Psychological Distress, Comorbidities, and Health Behaviors among U.S. Adults with Seizures: Results from the 2002 National Health Interview Survey. Epilepsia 2005, 46, 1133–1139. [Google Scholar] [CrossRef] [PubMed]
- Zack, M.; Luncheon, C. Adults with an Epilepsy History, Notably Those 45–64 years Old or at the Lowest Income Levels, More Often Report Heart Disease than Adults without an Epilepsy History. Epilepsy Behav. 2018, 86, 208–210. [Google Scholar] [CrossRef] [PubMed]
- Li, X.; Breteler, M.M.B.; De Bruyne, M.C.; Meinardi, H.; Hauser, W.A.; Hofman, A. Vascular Determinants of Epilepsy: The Rotterdam Study. Epilepsia 1997, 38, 1216–1220. [Google Scholar] [CrossRef] [PubMed]
- Selassie, A.W.; Wilson, D.A.; Martz, G.U.; Smith, G.G.; Wagner, J.L.; Wannamaker, B.B. Epilepsy beyond Seizure: A Population-Based Study of Comorbidities. Epilepsy Res. 2014, 108, 305–315. [Google Scholar] [CrossRef]
- Seidenberg, M.; Pulsipher, D.T.; Hermann, B. Association of Epilepsy and Comorbid Conditions. Future Neurol. 2009, 4, 663–668. [Google Scholar] [CrossRef] [Green Version]
- Druschky, A.; Hilz, M.J.; Hopp, P.; Platsch, G.; Radespiel-Trösger, M.; Druschky, K.; Kuwert, T.; Stefan, H.; Neundörfer, B. Interictal Cardiac Autonomic Dysfunction in Temporal Lobe Epilepsy Demonstrated by [123I]Metaiodobenzylguanidine-SPECT. Brain 2001, 124, 2372–2382. [Google Scholar] [CrossRef] [Green Version]
- Tomson, T.; Ericson, M.; Ihrman, C.; Lindblad, L.E. Heart Rate Variability in Patients with Epilepsy. Epilepsy Res. 1998, 30, 77–83. [Google Scholar] [CrossRef]
- Ronkainen, E.; Ansakorpi, H.; Huikuri, H.V.; Myllylä, V.V.; Isojärvi, J.I.T.; Korpelainen, J.T. Suppressed Circadian Heart Rate Dynamics in Temporal Lobe Epilepsy. J. Neurol. Neurosurg. Psychiatry 2005, 76, 1382–1386. [Google Scholar] [CrossRef] [PubMed]
- Goit, R.K.; Jha, S.K.; Pant, B.N. Alteration of Cardiac Autonomic Function in Patients with Newly Diagnosed Epilepsy. Physiol. Rep. 2016, 4. [Google Scholar] [CrossRef] [Green Version]
- Suorsa, E.; Korpelainen, J.T.; Ansakorpi, H.; Huikuri, H.V.; Suorsa, V.; Myllylä, V.V.; Isojärvi, J.I.T. Heart Rate Dynamics in Temporal Lobe Epilepsy-A Long-Term Follow-up Study. Epilepsy Res. 2011, 93, 80–83. [Google Scholar] [CrossRef] [PubMed]
- Falconer, B.; Rajs, J. Post-Mortem Findings of Cardiac Lesions in Epileptics: A Preliminary Report. Forensic Sci. 1976, 8, 63–71. [Google Scholar] [CrossRef]
- Natelson, B.H.; Suarez, R.V.; Terrence, C.F.; Turizo, R. Patients with Epilepsy Who Die Suddenly Have Cardiac Disease. Arch. Neurol. 1998, 55, 857–860. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Simona, P.; Dalager-Pedersen, S.; Baandrup, U.; Dam, M.; Vesterby-Charles, A. Sudden Unexpected Death in Epilepsy: Is Death by Seizures a Cardiac Disease? Am. J. Forensic Med. Pathol. 2005, 26, 99–105. [Google Scholar] [CrossRef]
- Bateman, L.M.; Li, C.S.; Seyal, M. Ictal Hypoxemia in Localization-Related Epilepsy: Analysis of Incidence, Severity and Risk Factors. Brain 2008, 131, 3239–3245. [Google Scholar] [CrossRef] [PubMed]
- Seyal, M.; Pascual, F.; Lee, C.Y.M.; Li, C.S.; Bateman, L.M. Seizure-Related Cardiac Repolarization Abnormalities Are Associated with Ictal Hypoxemia. Epilepsia 2011, 52, 2105–2111. [Google Scholar] [CrossRef] [Green Version]
- Moseley, B.D.; Wirrell, E.C.; Nickels, K.; Johnson, J.N.; Ackerman, M.J.; Britton, J. Electrocardiographic and Oximetric Changes during Partial Complex and Generalized Seizures. Epilepsy Res. 2011, 95, 237–245. [Google Scholar] [CrossRef]
- Kändler, L.; Fiedler, A.; Scheer, K.; Wild, F.; Frick, U.; Schneider, P. Early Post-Convulsive Prolongation of QT Time in Children. Acta Paediatr. Int. J. Paediatr. 2005, 94, 1243–1247. [Google Scholar] [CrossRef]
- Drake, M.E.; Reider, C.R.; Kay, A. Electrocardiography in Epilepsy Patients without Cardiac Symptoms. Seizure 1993, 2, 63–65. [Google Scholar] [CrossRef]
- Surges, R.; Adjei, P.; Kallis, C.; Erhuero, J.; Scott, C.A.; Bell, G.S.; Sander, J.W.; Walker, M.C. Pathologic Cardiac Repolarization in Pharmacoresistant Epilepsy and Its Potential Role in Sudden Unexpected Death in Epilepsy: A Case-Control Study. Epilepsia 2010, 51, 233–242. [Google Scholar] [CrossRef] [PubMed]
- Teh, H.S.; Tan, H.J.; Loo, C.Y.; Raymond, A.A. Short QTc in Epilepsy Patients without Cardiac Symptoms. Med. J. Malays. 2007, 62, 104–108. [Google Scholar]
- Shah, A.J.; Bhosale, A.; Bangar, P.; Jain, A.; Toadkar, J.; Rawat, S.; Kerkar, P.G. QTc Interval in Idiopathic Epilepsy. J. Assoc. Physicians India 2005, 53, 577–578. [Google Scholar]
- Kishk, N.A.; Sharaf, Y.; Ebraheim, A.M.; Baghdady, Y.; Alieldin, N.; Afify, A.; Eldamaty, A. Interictal Cardiac Repolarization Abnormalities in People with Epilepsy. Epilepsy Behav. 2018, 79, 106–111. [Google Scholar] [CrossRef]
- Priest, B.T.; McDermott, J.S. Cardiac Ion Channels. Channels 2015, 9, 352–359. [Google Scholar] [CrossRef] [PubMed]
- Lerche, H.; Shah, M.; Beck, H.; Noebels, J.; Johnston, D.; Vincent, A. Ion Channels in Genetic and Acquired Forms of Epilepsy. J. Physiol. 2013, 591, 753–764. [Google Scholar] [CrossRef]
- Li, M.C.H.; O’Brien, T.J.; Todaro, M.; Powell, K.L. Acquired Cardiac Channelopathies in Epilepsy: Evidence, Mechanisms, and Clinical Significance. Epilepsia 2019, 60, 1753–1767. [Google Scholar] [CrossRef]
- Goldman, A.M.; Glasscock, E.; Yoo, J.; Chen, T.T.; Klassen, T.L.; Noebels, J.L. Arrhythmia in Heart and Brain: KCNQ1 Mutations Link Epilepsy and Sudden Unexplained. Sci. Transl. Med. 2009, 1, 2ra6. [Google Scholar] [CrossRef] [Green Version]
- Lehnart, S.E.; Mongillo, M.; Bellinger, A.; Lindegger, N.; Chen, B.X.; Hsueh, W.; Reiken, S.; Wronska, A.; Drew, L.J.; Ward, C.W.; et al. Leaky Ca2+ Release Channel/Ryanodine Receptor 2 Causes Seizures and Sudden Cardiac Death in Mice. J. Clin. Investig. 2008, 118, 2230–2245. [Google Scholar] [CrossRef] [Green Version]
- Zamorano-León, J.J.; Yañez, R.; Jaime, G.; Rodriguez-Sierra, P.; Calatrava-Ledrado, L.; Alvarez-Granada, R.R.; Mateos-Cáceres, P.J.; MacAya, C.; López-Farré, A.J. KCNH2 Gene Mutation: A Potential Link between Epilepsy and Long QT-2 Syndrome. J. Neurogenet. 2012, 26, 382–386. [Google Scholar] [CrossRef]
- Johnson, J.N.; Hofman, N.; Haglund, C.M.; Cascino, G.D.; Wilde, A.A.M.; Ackerman, M.J. Identification of a Possible Pathogenic Link between Congenital Long QT Syndrome and Epilepsy. Neurology 2009, 72, 224–231. [Google Scholar] [CrossRef] [Green Version]
- Olberg, H.K.; Odland, H.H.; Kask, A.; Engelsen, B.A. A Woman in Her Thirties with Seizure Relapse after a Previous Diagnosis of Epilepsy. Tidsskr. Nor. Laegeforen. 2018, 138. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Parisi, P.; Oliva, A.; Coll Vidal, M.; Partemi, S.; Campuzano, O.; Iglesias, A.; Pisani, D.; Pascali, V.L.; Paolino, M.C.; Villa, M.P.; et al. Coexistence of Epilepsy and Brugada Syndrome in a Family with SCN5A Mutation. Epilepsy Res. 2013, 105, 415–418. [Google Scholar] [CrossRef] [PubMed]
- Tu, E.; Bagnall, R.D.; Duflou, J.; Semsarian, C. Post-Mortem Review and Genetic Analysis of Sudden Unexpected Death in Epilepsy (SUDEP) Cases. Brain Pathol. 2011, 21, 201–208. [Google Scholar] [CrossRef] [PubMed]
- Johnson, J.N.; Tester, D.J.; Bass, N.E.; Ackerman, M.J. Cardiac Channel Molecular Autopsy for Sudden Unexpected Death in Epilepsy. J. Child Neurol. 2010, 25, 916–921. [Google Scholar] [CrossRef] [PubMed]
- Verrier, R.L.; Pang, T.D.; Nearing, B.D.; Schachter, S.C. The Epileptic Heart: Concept and Clinical Evidence. Epilepsy Behav. 2020, 105, 106946. [Google Scholar] [CrossRef] [PubMed]
- Sagie, A.; Larson, M.G.; Goldberg, R.J.; Bengtson, J.R.; Levy, D. An Improved Method for Adjusting the QT Interval for Heart Rate (the Framingham Heart Study). Am. J. Cardiol. 1992, 70, 797–801. [Google Scholar] [CrossRef]
- Rautaharju, P.M.; Surawicz, B.; Gettes, L.S. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. Part IV: The ST Segment, T and U Waves, and the QT Interval A Scientific Statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. J. Am. Coll. Cardiol. 2009, 53, 982–991. [Google Scholar] [CrossRef] [Green Version]
- Fridericia, L.S. Die Systolendauer Im Elektrokardiogramm Bei Normalen Menschen Und Bei Herzkranken. Acta Med. Scand. 2009, 54, 17–50. [Google Scholar] [CrossRef]
- Scheffer, I.E.; Berkovic, S.; Capovilla, G.; Connolly, M.B.; French, J.; Guilhoto, L.; Hirsch, E.; Jain, S.; Mathern, G.W.; Moshé, S.L.; et al. ILAE Classification of the Epilepsies: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017, 58, 512–521. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Suna, N. Neurological Letter from Latvia. Pract. Neurol. 2014, 14, 415–417. [Google Scholar] [CrossRef]
- Hitiris, N.; Mohanraj, R.; Norrie, J.; Brodie, M.J. Mortality in Epilepsy. Epilepsy Behav. 2007, 10, 363–376. [Google Scholar] [CrossRef] [PubMed]
- Dogan, E.A.; Dogan, U.; Yildiz, G.U.; Akilli, H.; Genc, E.; Genc, B.O.; Gok, H. Evaluation of Cardiac Repolarization Indices in Well-Controlled Partial Epilepsy: 12-Lead ECG Findings. Epilepsy Res. 2010, 90, 157–163. [Google Scholar] [CrossRef]
- Krishnan, V.; Krishnamurthy, K.B. Interictal 12-Lead Electrocardiography in Patients with Epilepsy. Epilepsy Behav. 2013, 29, 240–246. [Google Scholar] [CrossRef]
- Ramadan, M.M.; El-Shahat, N.; Omar, A.A.; Gomaa, M.; Belal, T.; Sakr, S.A.; Abu-Hegazy, M.; Hakim, H.; Selim, H.A.; Omar, S.A. Interictal Electrocardiographic and Echocardiographic Changes in Patients with Generalized Tonic-Clonic Seizures. Int. Heart J. 2013, 54, 171–175. [Google Scholar] [CrossRef] [PubMed]
- Neufeld, G.; Lazar, J.M.; Chari, G.; Kamran, H.; Akajagbor, E.; Salciccioli, L.; Kassotis, J.; Stewart, M. Cardiac Repolarization Indices in Epilepsy Patients. Cardiology 2009, 114, 255–260. [Google Scholar] [CrossRef]
- de Sousa, J.M.B.; Fialho, G.L.; Wolf, P.; Walz, R.; Lin, K. Determining Factors of Electrocardiographic Abnormalities in Patients with Epilepsy: A Case-Control Study. Epilepsy Res. 2017, 129, 106–116. [Google Scholar] [CrossRef] [PubMed]
- Ufongene, C.; El Atrache, R.; Loddenkemper, T.; Meisel, C. Electrocardiographic Changes Associated with Epilepsy beyond Heart Rate and Their Utilization in Future Seizure Detection and Forecasting Methods. Clin. Neurophysiol. 2020, 131, 866–879. [Google Scholar] [CrossRef] [PubMed]
- Chyou, J.Y.; Friedman, D.; Cerrone, M.; Slater, W.; Guo, Y.; Taupin, D.; O’Rourke, S.; Priori, S.G.; Devinsky, O. Electrocardiographic Features of Sudden Unexpected Death in Epilepsy. Epilepsia 2016, 57, e135–e139. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bardai, A.; Blom, M.T.; van Noord, C.; Verhamme, K.M.; Sturkenboom, M.C.J.M.; Tan, H.L. Sudden Cardiac Death Is Associated Both with Epilepsy and with Use of Antiepileptic Medications. Heart 2015, 101, 17–22. [Google Scholar] [CrossRef] [Green Version]
- Bauer, P.R.; Novy, J.; Keezer, M.R.; Bell, G.S. Sudden Cardiac Death Is Associated both with Epilepsy and with Use of Antiepileptic Drugs. Heart 2015, 101, 83. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lin, Y.-L.; Kung, M.-F. Magnitude of QT Prolongation Associated with a Higher Risk of Torsades de Pointes. Pharmacoepidemiol. Drug Saf. 2009, 18, 235–239. [Google Scholar] [CrossRef] [PubMed]
- Priori, S.G.; Wilde, A.A.; Horie, M.; Cho, Y.; Behr, E.R.; Berul, C.; Blom, N.; Brugada, J.; Chiang, C.E.; Huikuri, H.; et al. Executive Summary: HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes. Heart Rhythm 2013, 10, 1932–1963. [Google Scholar] [CrossRef] [PubMed]
- Levine, E.; Rosero, S.Z.; Budzikowski, A.S.; Moss, A.J.; Zareba, W.; Daubert, J.P. Congenital Long QT Syndrome: Considerations for Primary Care Physicians. Cleve. Clin. J. Med. 2008, 75, 591–600. [Google Scholar] [CrossRef]
- Vink, A.S.; Neumann, B.; Lieve, K.V.V.; Sinner, M.F.; Hofman, N.; el Kadi, S.; Schoenmaker, M.H.A.; Slaghekke, H.M.J.; de Jong, J.S.S.G.; Clur, S.-A.B.; et al. Determination and Interpretation of the QT Interval. Circulation 2018, 138, 2345–2358. [Google Scholar] [CrossRef] [PubMed]
- Hayashi, K.; Kohno, R.; Akamatsu, N.; Benditt, D.G.; Abe, H. Abnormal Repolarization: A Common Electrocardiographic Finding in Patients with Epilepsy. J. Cardiovasc. Electrophysiol. 2019, 30, 109–115. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mizusawa, Y.; Wilde, A.A.M. Brugada Syndrome. Circ. Arrhythmia Electrophysiol. 2012, 5, 606–616. [Google Scholar] [CrossRef] [Green Version]
- Bao, H.; Cai, H.; Zhao, Y.; Huang, X.; Fan, F.; Zhang, C.; Li, J.; Chen, J.; Hong, K.; Li, P.; et al. Nonspecific ST-T Changes Associated with Unsatisfactory Blood Pressure Control among Adults with Hypertension in China: Evidence from the CSPTT Study. Medicine 2017, 96, e6423. [Google Scholar] [CrossRef] [PubMed]
Parameter | Alive and the Parameter Was Present | Deceased and the Parameter Was Present | p Value |
---|---|---|---|
Short QTc (n = 19) | 3.4% (n = 11) | 7.5% (n = 8) | 0.068 |
Long QTc (n = 23) | 4% (n = 13) | 9.4% (n = 10) | 0.043 |
Short QTc Fridericia (n = 29) | 5.5% (n = 18) | 10.4% (n = 11) | 0.080 |
Long QTc Fridericia (n = 20) | 3.3% (n = 11) | 8.3% (n = 9) | 0.067 |
Nonspecific ST-T changes (n = 113) * | 22.7% (n = 75) | 35.2% (n = 38) | 0.016 |
Intraventricular conduction disturbances (n = 89) * | 19.1% (n = 63) | 24.1% (n = 26) | 0.272 |
Intra-atrial conduction disturbances (n = 29) | 4.2% (n = 14) | 13.9% (n = 15) | 0.001 |
Left ventricular hypertrophy (n = 54) | 8.2% (n = 27) | 25% (n = 27) | <0.005 |
Pathologic Q wave changes (n = 23) * | 3.3% (n = 11) | 11.1% (n = 12) | 0.004 |
Atrioventricular block (n = 13) | 2.4% (n = 8) | 4.6% (n = 5) | 0.323 |
Early repolarization (n = 7) | 1.8% (n = 6) | 0.9% (n = 1) | >0.999 |
WPW syndrome (n = 2) | 0.3% (n = 1) | 0.9% (n = 1) | 0.433 |
Parameter | Alive and the Parameter Was Present | Deceased and the Parameter Was Present | p Value |
---|---|---|---|
Short QTc (n = 14) | 3.7% (n = 9) | 10.6% (n = 5) | 0.042 |
Long QTc (n = 10) | 2.9% (n = 7) | 6.4% (n = 3) | 0.208 |
Short QTc Fridericia (n = 19) | 5.7% (n = 14) | 10.4% (n = 5) | 0.226 |
Long QTc Fridericia (n = 7) | 1.6% (n = 4) | 6.3% (n = 3) | 0.055 |
Nonspecific ST-T changes (n = 63) | 20.0% (n = 49) | 29.2% (n = 14) | 0.157 |
Intraventricular conduction disturbances (n = 55) | 18.4% (n = 45) | 20.8% (n = 10) | 0.689 |
Intra-atrial conduction disturbances (n = 15) | 4.1% (n = 10) | 10.4% (n = 5) | 0.079 |
Left ventricular hypertrophy (n = 21) | 4.5% (n = 11) | 20.8% (n = 10) | <0.005 |
Pathologic Q wave changes (n = 5) | 1.2% (n = 3) | 4.2% (n = 2) | 0.190 |
Atrioventricular block (n = 6) | 2.4% (n = 6) | 0% (n = 0) | 0.594 |
Early repolarization (n = 7) | 2.4% (n = 6) | 2.1% (n = 1) | >0.999 |
WPW syndrome (n = 1) | 0.4% (n = 1) | 0% (n = 0) | >0.999 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Suna, N.; Suna, I.; Gutmane, E.; Kande, L.; Karelis, G.; Viksna, L.; Folkmanis, V. Electrocardiographic Abnormalities and Mortality in Epilepsy Patients. Medicina 2021, 57, 504. https://doi.org/10.3390/medicina57050504
Suna N, Suna I, Gutmane E, Kande L, Karelis G, Viksna L, Folkmanis V. Electrocardiographic Abnormalities and Mortality in Epilepsy Patients. Medicina. 2021; 57(5):504. https://doi.org/10.3390/medicina57050504
Chicago/Turabian StyleSuna, Normunds, Inga Suna, Evija Gutmane, Linda Kande, Guntis Karelis, Ludmila Viksna, and Valdis Folkmanis. 2021. "Electrocardiographic Abnormalities and Mortality in Epilepsy Patients" Medicina 57, no. 5: 504. https://doi.org/10.3390/medicina57050504