Electrocardiographic Abnormalities and Mortality in Epilepsy Patients

Area of Science:

• Cardiology
• Neurology
• Clinical Medicine

Background:

• People with epilepsy (PWE) exhibit a 2-3 fold increased mortality rate compared to the general population.
• Sudden unexpected death in epilepsy (SUDEP) and sudden cardiac death (SCD) contribute significantly to premature mortality.
• Cardiac pathologies are more prevalent in PWE, suggesting a link between cardiac function and epilepsy-related mortality.

Purpose of the Study:

• To investigate the association between interictal electrocardiographic (ECG) parameters and long-term mortality in epilepsy patients.
• To determine if specific ECG findings predict remote death in individuals with epilepsy.
• To explore the relationship between cardiac electrical activity and mortality risk in the epileptic population.

Main Methods:

• A cohort of 471 epilepsy patients hospitalized after bilateral tonic-clonic seizures was studied.
• Electrocardiographic (ECG) parameters, including heart rate, PQ, QRS, QT, and corrected QT (QTc) intervals, were recorded during hospitalization.
• Mortality data were collected from the national database over a mean follow-up of 7.0 years.

Main Results:

• 24.6% of the study cohort experienced mortality during the follow-up period.
• A short corrected QT interval (QTc) was significantly associated with an increased risk of remote death (OR 4.780, p=0.004).
• Even after excluding comorbidities, short QTc (OR 4.631) and ECG signs of left ventricular hypertrophy (OR 5.009) remained significant predictors of mortality.

Conclusions:

• Routine 12-lead resting ECG parameters, specifically a short QTc interval and left ventricular hypertrophy, are associated with remote death in epilepsy patients.
• This study is the first to establish a link between resting ECG parameters and long-term mortality in an epileptic population.
• These findings highlight the potential of ECG as a non-invasive tool for risk stratification in individuals with epilepsy.