Lengthening of corrected QT during epileptic seizures

Abstract

SUMMARYPurpose: To measure the corrected QT cardiac repolarization time before and during epileptic seizures. Methods: Thirty-nine video-EEG/ECG/SAO 2 (electroencephalography/electrocardiography/oxygen saturation) telemetry patients were included in this prospective study. Epileptic seizures were identified both clinically and electrographically. RR intervals and associated QT intervals were measured 5 min prior to the onset of the identified seizure. Consecutive RR and associated QT intervals were then measured from the seizure onset until the seizure had ended and the EEG had resumed its preseizure trace. Averaged RR and QT intervals over nine consecutive beats were applied to Bazett's, Hodge's, Fridericia's, and Framingham's formulas to compare the corrected QT values before and during the seizures.

Inhibition of microglial activation with minocycline at the intrathecal level attenuates sympathoexcitatory and proarrhythmogenic changes in rats with chronic temporal lobe epilepsy

“…Cardiovascular autonomic dysfunction with profound arrhythmogenic effects, including prolongation of QT interval, QT dispersion, "T"-wave inversion, and tachycardia or bradycardia, are major risks for SUDEP in humans and animals with spontaneous recurrent seizures (Opherk et al, 2002;Sakamoto et al, 2008;Metcalf et al, 2009;Brotherstone et al, 2010;Powell et al, 2014b;Eastaugh et al, 2015;Lamberts et al, 2015). Activated microglia are present in post-SE rats (Shapiro et al, 2008), and during chronic periods of epilepsy in humans (Beach et al, 1995) and animals (Shapiro et al, 2008).…”

Sudden Unexpected Death in Epilepsy: An Overview

“…Other authors reported the opposite, i.e. a significant lengthening of corrected QT cardiac repolarization time during some epileptic seizures considering this QT abnormality a potential risk factor for SUDEP (Brotherstone et al, 2010). Anatomic examination of the heart of patients that died from SUDEP demonstrated an increased weight in some cases, suggesting that cardiac pathology including cardiac conduction pathology and coronary artery atheroma may contribute to SUDEP.…”

Cerebrogenic cardiopathy

“…An association between right temporal lobe seizures and QTc prolongation has been described [54], suggesting an effect on ventricular depolarization independent of heart rate. Bundle branch block, QT prolongation, T wave changes and first degree atrioventricular block were found in 35% of epileptics without evidence of underlying cardiac disease [55].…”