Abnormal repolarization: A common electrocardiographic finding in patients with epilepsy

Katsuhide Hayashi, Ritsuko Kohno, Naoki Akamatsu, David G Benditt, Haruhiko Abe

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Recently, certain forms of early repolarization (ER) on electrocardiograms (ECGs) have been considered a possible marker of increased sudden cardiac death risk. The frequency, characteristics, and clinical follow-up with which these forms of ER are present in epilepsy patients, and whether or not abnormal ER contributes to sudden unexplained death in epilepsy patients (SUDEP) is unknown. Methods and Results: The amplitude of J peak and ST-segment morphology after ER on 12-lead ECGs were assessed in 354 epilepsy patients (age, 33 ± 16 years; 54% men) and 140 age- and sex-matched control subjects (age, 31 ± 12 years; 50% men). Abnormal ER prevalence (J-wave amplitude ≥0.1 mV) was greater in epilepsy patients (19.8%) compared with controls (8.6%; P = 0.002) in inferior ECG leads but not in lateral leads (P = 0.40). ER with a horizontal or descending ST segment was also more prevalent in epilepsy patients (P < 0.001). After introducing antiepileptic drugs in 36 epilepsy patients, there were no significant ER changes. Similarly, in 64 epilepsy patients with seizure suppression, ER comparison before and after seizure control revealed no significant changes. Male gender was the only significant predictor of abnormal ER in epilepsy patients (P = 0.03). During a median follow-up of 7 years, SUDEP occurred in two patients, one with abnormal ER. Conclusions: Abnormal ER may be more prevalent in epilepsy patients than in controls and is not altered by antiepileptic drugs or achievement of epilepsy suppression. The relation of abnormal ER to SUDEP remains in need of further study.

Original languageEnglish (US)
Pages (from-to)109-115
Number of pages7
JournalJournal of cardiovascular electrophysiology
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Epilepsy
Sudden Death
Electrocardiography
Anticonvulsants
Seizures
Sudden Cardiac Death

Keywords

  • autonomic nervous system
  • early repolarization
  • electrocardiogram
  • epilepsy
  • sudden death

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

Abnormal repolarization : A common electrocardiographic finding in patients with epilepsy. / Hayashi, Katsuhide; Kohno, Ritsuko; Akamatsu, Naoki; Benditt, David G; Abe, Haruhiko.

In: Journal of cardiovascular electrophysiology, Vol. 30, No. 1, 01.01.2019, p. 109-115.

Research output: Contribution to journalArticle

Hayashi, Katsuhide ; Kohno, Ritsuko ; Akamatsu, Naoki ; Benditt, David G ; Abe, Haruhiko. / Abnormal repolarization : A common electrocardiographic finding in patients with epilepsy. In: Journal of cardiovascular electrophysiology. 2019 ; Vol. 30, No. 1. pp. 109-115.
@article{7448f600966c482a9bdb74b6499499a7,
title = "Abnormal repolarization: A common electrocardiographic finding in patients with epilepsy",
abstract = "Background: Recently, certain forms of early repolarization (ER) on electrocardiograms (ECGs) have been considered a possible marker of increased sudden cardiac death risk. The frequency, characteristics, and clinical follow-up with which these forms of ER are present in epilepsy patients, and whether or not abnormal ER contributes to sudden unexplained death in epilepsy patients (SUDEP) is unknown. Methods and Results: The amplitude of J peak and ST-segment morphology after ER on 12-lead ECGs were assessed in 354 epilepsy patients (age, 33 ± 16 years; 54{\%} men) and 140 age- and sex-matched control subjects (age, 31 ± 12 years; 50{\%} men). Abnormal ER prevalence (J-wave amplitude ≥0.1 mV) was greater in epilepsy patients (19.8{\%}) compared with controls (8.6{\%}; P = 0.002) in inferior ECG leads but not in lateral leads (P = 0.40). ER with a horizontal or descending ST segment was also more prevalent in epilepsy patients (P < 0.001). After introducing antiepileptic drugs in 36 epilepsy patients, there were no significant ER changes. Similarly, in 64 epilepsy patients with seizure suppression, ER comparison before and after seizure control revealed no significant changes. Male gender was the only significant predictor of abnormal ER in epilepsy patients (P = 0.03). During a median follow-up of 7 years, SUDEP occurred in two patients, one with abnormal ER. Conclusions: Abnormal ER may be more prevalent in epilepsy patients than in controls and is not altered by antiepileptic drugs or achievement of epilepsy suppression. The relation of abnormal ER to SUDEP remains in need of further study.",
keywords = "autonomic nervous system, early repolarization, electrocardiogram, epilepsy, sudden death",
author = "Katsuhide Hayashi and Ritsuko Kohno and Naoki Akamatsu and Benditt, {David G} and Haruhiko Abe",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/jce.13746",
language = "English (US)",
volume = "30",
pages = "109--115",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Abnormal repolarization

T2 - A common electrocardiographic finding in patients with epilepsy

AU - Hayashi, Katsuhide

AU - Kohno, Ritsuko

AU - Akamatsu, Naoki

AU - Benditt, David G

AU - Abe, Haruhiko

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Recently, certain forms of early repolarization (ER) on electrocardiograms (ECGs) have been considered a possible marker of increased sudden cardiac death risk. The frequency, characteristics, and clinical follow-up with which these forms of ER are present in epilepsy patients, and whether or not abnormal ER contributes to sudden unexplained death in epilepsy patients (SUDEP) is unknown. Methods and Results: The amplitude of J peak and ST-segment morphology after ER on 12-lead ECGs were assessed in 354 epilepsy patients (age, 33 ± 16 years; 54% men) and 140 age- and sex-matched control subjects (age, 31 ± 12 years; 50% men). Abnormal ER prevalence (J-wave amplitude ≥0.1 mV) was greater in epilepsy patients (19.8%) compared with controls (8.6%; P = 0.002) in inferior ECG leads but not in lateral leads (P = 0.40). ER with a horizontal or descending ST segment was also more prevalent in epilepsy patients (P < 0.001). After introducing antiepileptic drugs in 36 epilepsy patients, there were no significant ER changes. Similarly, in 64 epilepsy patients with seizure suppression, ER comparison before and after seizure control revealed no significant changes. Male gender was the only significant predictor of abnormal ER in epilepsy patients (P = 0.03). During a median follow-up of 7 years, SUDEP occurred in two patients, one with abnormal ER. Conclusions: Abnormal ER may be more prevalent in epilepsy patients than in controls and is not altered by antiepileptic drugs or achievement of epilepsy suppression. The relation of abnormal ER to SUDEP remains in need of further study.

AB - Background: Recently, certain forms of early repolarization (ER) on electrocardiograms (ECGs) have been considered a possible marker of increased sudden cardiac death risk. The frequency, characteristics, and clinical follow-up with which these forms of ER are present in epilepsy patients, and whether or not abnormal ER contributes to sudden unexplained death in epilepsy patients (SUDEP) is unknown. Methods and Results: The amplitude of J peak and ST-segment morphology after ER on 12-lead ECGs were assessed in 354 epilepsy patients (age, 33 ± 16 years; 54% men) and 140 age- and sex-matched control subjects (age, 31 ± 12 years; 50% men). Abnormal ER prevalence (J-wave amplitude ≥0.1 mV) was greater in epilepsy patients (19.8%) compared with controls (8.6%; P = 0.002) in inferior ECG leads but not in lateral leads (P = 0.40). ER with a horizontal or descending ST segment was also more prevalent in epilepsy patients (P < 0.001). After introducing antiepileptic drugs in 36 epilepsy patients, there were no significant ER changes. Similarly, in 64 epilepsy patients with seizure suppression, ER comparison before and after seizure control revealed no significant changes. Male gender was the only significant predictor of abnormal ER in epilepsy patients (P = 0.03). During a median follow-up of 7 years, SUDEP occurred in two patients, one with abnormal ER. Conclusions: Abnormal ER may be more prevalent in epilepsy patients than in controls and is not altered by antiepileptic drugs or achievement of epilepsy suppression. The relation of abnormal ER to SUDEP remains in need of further study.

KW - autonomic nervous system

KW - early repolarization

KW - electrocardiogram

KW - epilepsy

KW - sudden death

UR - http://www.scopus.com/inward/record.url?scp=85055724628&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055724628&partnerID=8YFLogxK

U2 - 10.1111/jce.13746

DO - 10.1111/jce.13746

M3 - Article

C2 - 30230121

AN - SCOPUS:85055724628

VL - 30

SP - 109

EP - 115

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 1

ER -