Cardiac effects of carbamazepine treatment in childhood epilepsy
Ebru Arhan1, Semsettin Ayçiçek, Nursel Akaln
1Department of Pediatrics, Ankara Dişkapi Children's Hospital, Ankara, Turkey. petekarhan@yahoo.com.tr
Insights
Carbamazepine (CBZ) treatment in children with epilepsy did not significantly affect left ventricular function or cause electrocardiographic changes. This suggests CBZ is safe for pediatric cardiac patients without prior heart conditions.
Area of Science:
- Pediatric Cardiology
- Clinical Pharmacology
- Neurology
Background:
- Carbamazepine (CBZ) is known to cause cardiovascular side effects like hypotension and bradycardia.
- Direct impacts of CBZ on ventricular function are infrequently documented.
- Pediatric patients require specific evaluation for drug-induced cardiac effects.
Purpose of the Study:
- To investigate the effects of therapeutic doses of carbamazepine on ventricular function in pediatric epilepsy patients.
- To determine if CBZ induces ventricular dysfunction or electrocardiographic changes in children without pre-existing cardiac disease.
Main Methods:
- A cohort of 40 pediatric epilepsy patients treated with carbamazepine was studied.
- Electroencephalography, electrocardiography, and echocardiography were performed at baseline and at 3 and 12 months.
- Left ventricular systolic and diastolic functions were assessed using echocardiographic parameters like fractional shortening (FS) and ejection fraction (EF).
Main Results:
- No electrocardiographic abnormalities were observed during the 1-year follow-up period.
- Fractional shortening (FS) and ejection fraction (EF) showed no statistically significant changes, indicating preserved left ventricular function.
- Carbamazepine at therapeutic doses did not adversely affect ventricular function in this pediatric cohort.
Conclusions:
- Carbamazepine appears to be a safe medication for pediatric epileptic patients without pre-existing cardiac conditions.
- Close monitoring of cardiac function is recommended for pediatric patients with risk factors when initiating carbamazepine therapy.
Objective:
Hypotension, bradycardia, and atrioventricular block are well-known cardiovascular effects of carbamazepine (CBZ). However, direct effects of CBZ on ventricular functions have been rarely encountered. We investigated the effect of CBZ on ventricular functions in pediatric patients without previous cardiac disease to determine whether CBZ causes ventricular dysfunction or electrocardiographic changes in therapeutic doses in children.
Methods:
The study includes 40 patients (31 boys, 9 girls) with epilepsy who had been treated with carbamazepine. Electroencephalography, electrocardiography, echocardiography, and cranial imaging were performed on all patients before treatment and were repeated at the end of the third and 12th months of treatment. The systolic and diastolic thickness of the interventricular septum and the posterior wall of the left ventricle and the systolic and diastolic diameter of the left ventricle were measured during M-mode investigation. The end-systolic and end-diastolic volumes (mL), the stroke volume (mL), fractional shortening (FS), (%) and ejection fraction (EF) (%) measurements were obtained from the computer on the echocardiography device.
Results:
In 1-year follow-up, no electrocardiographic abnormalities were detected. The FS and EF values showing left ventricular function did not show a significant difference (P > 0.05).
Conclusions:
CBZ seems to be a safe drug in pediatric epileptic patients without any preexisting cardiac disease. We suggest that the risk factors should be defined and followed-up regarding cardiac function when treatment is initiated in groups with risk factors.
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