The Epileptic Heart and the Case for Routine Use of the Electrocardiogram in Patients with Chronic Epilepsy

Verrier, Richard L.; Pang, Trudy; Nearing, Bruce D.; Schachter, Steven C.

doi:10.1016/j.ncl.2022.03.003

Cited by 5 publications

(4 citation statements)

References 55 publications

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“…VNS-induced cardiovascular complications have rarely been reported (37,38,39). Conversely, the current state of knowledge suggests that VNS exhibits a significant cardioprotective effect by two separate mechanisms: affecting the central nervous system leading to seizure reduction, and direct influence on the heart leading to a decrease in its electrical instability (40).…”

Section: Structural Cardiovascular Abnormalities and Arrhythmias In E...mentioning

confidence: 99%

“…82% of patients with epilepsy have elevated TWA values that are dependent on the duration of epilepsy, meaning that patients with chronic epilepsy display higher TWA values compared to the newly diagnosed ones (46,47). Furthermore, TWA is influenced by the pro and antiarrhythmic effects of drugs, as well as VNS which was shown to significantly reduce TWA (40).…”

Section: Ecg Findings In Epilepsymentioning

confidence: 99%

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Cardiovascular comorbidities in epileptology

Petelin Gadže,

Hodžić,

Bujan Kovač

et al. 2023

Rad Hrvatske akademije znanosti i umjetnosti

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Epilepsy is one of the most common neurological diseases affecting around 50 million people worldwide. Modern scientific and professional literature recognizes comorbidities as an integral part of epilepsy, with the goal of defining optimal treatment. A series of studies from 2002 to date have confirmed a high prevalence of heart diseases in all age groups of adult patients with epilepsy, and nearly three times higher risk of malignant arrhythmias and sudden cardiac death, compared to the general population. Currently, research is increasingly being focused on elucidating the long-term connection between epilepsy and the cardiovascular system, and in 2020 the term ''epileptic heart'' was first introduced, describing a heart and coronary vasculature damaged by chronic epilepsy. Plausible pathophysiological mechanisms include the cardiotoxic effects of catecholamines and repeated hypoxemia, but also the use of antiseizure medications (ASMs) associated with hyperlipidemia and arrhythmogenic effects, which could make an additional contribution to the electromechanical dysfunction of the heart. People over 60 years of age make up the largest group of patients with newly diagnosed epilepsy and represent a particular challenge for epileptologists, due to the frequent presence of multimorbidity and polypharmacy, especially in the domain of the cardiovascular system. The International League Against Epilepsy (ILAE) Task Force on Epilepsy in the elderly proposed guidelines that state that clinicians need to approach an elderly person as they would a woman of childbearing potential, and emphasize the importance of considering factors such as adverse effects and pharmacokinetic interactions when choosing ASMs, as well as the necessity for an individualized, multidisciplinary and patient-oriented approach. In addition, recent studies draw attention to the need for a routine cardiological assessment when treating patients with epilepsy, and highlight the importance of electrocardiogram (ECG) in determining the initial cardiovascular risk, as well as monitoring the impact of epileptic seizures and ASMs on the structural integrity of the heart and its vasculature.

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Section: Structural Cardiovascular Abnormalities and Arrhythmias In E...mentioning

confidence: 99%

Section: Ecg Findings In Epilepsymentioning

confidence: 99%

Cardiovascular comorbidities in epileptology

Petelin Gadže,

Hodžić,

Bujan Kovač

et al. 2023

Rad Hrvatske akademije znanosti i umjetnosti

View full text Add to dashboard Cite

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“…Other surgical complications include cerebrospinal fluid leak, postoperative hydrocephalus, and wound site infection. Perioperative mortality is an uncommon and has been reported in 0.4% of temporal lobe epilepsy and 1.2% extratemporal epilepsy 57,58 …”

Section: Preoperative Assessmentmentioning

confidence: 99%

“…Perioperative mortality is an uncommon and has been reported in 0.4% of temporal lobe epilepsy and 1.2% extratemporal epilepsy. 57,58 Underlying mechanism is not well known. Though there are no reports on relation between epilepsy surgery and sudden unexpected death in epilepsy (SUDEP), but VNS has been proposed to decrease the risk of SUDEP in DRE.…”

Section: Neurological Complicationsmentioning

confidence: 99%