Increased prevalence of ECG markers for sudden cardiac arrest in refractory epilepsy.

Détails

Ressource 1Télécharger: jnnp-2014-307772.pdf (396.97 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_87C76804A388
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Increased prevalence of ECG markers for sudden cardiac arrest in refractory epilepsy.
Périodique
Journal of Neurology, Neurosurgery, and Psychiatry
Auteur(s)
Lamberts R.J., Blom M.T., Novy J., Belluzzo M., Seldenrijk A., Penninx B.W., Sander J.W., Tan H.L., Thijs R.D.
ISSN
1468-330X (Electronic)
ISSN-L
0022-3050
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
86
Numéro
3
Pages
309-313
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
BACKGROUND AND AIM: People with epilepsy are at increased risk of sudden cardiac arrest (SCA) due to ECG-confirmed ventricular tachycardia/fibrillation, as seen in a community-based study. We aimed to determine whether ECG-risk markers of SCA are more prevalent in people with epilepsy.
METHODS: In a cross-sectional, retrospective study, we analysed the ECG recordings of 185 people with refractory epilepsy and 178 controls without epilepsy. Data on epilepsy characteristics, cardiac comorbidity, and drug use were collected, and general ECG variables (heart rate (HR), PQ and QRS intervals) assessed. We analysed ECGs for three markers of SCA risk: severe QTc prolongation (male >450 ms, female >470 ms), Brugada ECG pattern, and early repolarisation pattern (ERP). Multivariate regression models were used to analyse differences between groups, and to identify associated clinical and epilepsy-related characteristics.
RESULTS: People with epilepsy had higher HR (71 vs 62 bpm, p<0.001) and a longer PQ interval (162.8 vs 152.6 ms, p=0.001). Severe QTc prolongation and ERP were more prevalent in people with epilepsy (QTc prolongation: 5% vs 0%; p=0.002; ERP: 34% vs 13%, p<0.001), while the Brugada ECG pattern was equally frequent in both groups (2% vs 1%, p>0.999). After adjustment for covariates, epilepsy remained associated with ERP (ORadj 2.4, 95% CI 1.1 to 5.5) and severe QTc prolongation (ORadj 9.9, 95% CI 1.1 to 1317.7).
CONCLUSIONS: ERP and severe QTc prolongation appear to be more prevalent in people with refractory epilepsy. Future studies must determine whether this contributes to increased SCA risk in people with epilepsy.
Mots-clé
Adolescent, Adult, Aged, Anticonvulsants/therapeutic use, Biological Markers, Cause of Death, Cross-Sectional Studies, Death, Sudden, Cardiac/epidemiology, Drug Resistance, Electrocardiography, Epilepsy/drug therapy, Epilepsy/epidemiology, Female, Heart Rate, Humans, Long QT Syndrome/drug therapy, Long QT Syndrome/epidemiology, Male, Middle Aged, Netherlands, Risk Factors, Signal Processing, Computer-Assisted, Statistics as Topic, Tachycardia, Ventricular/drug therapy, Tachycardia, Ventricular/epidemiology, Ventricular Fibrillation/drug therapy, Ventricular Fibrillation/epidemiology, Young Adult
Pubmed
Web of science
Open Access
Oui
Création de la notice
05/06/2015 9:52
Dernière modification de la notice
08/05/2019 21:30
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