Electrocardiographic repolarization and conduction abnormalities in pediatric epilepsy

Area of Science:

• Pediatric Cardiology
• Clinical Electrophysiology
• Neurology

Background:

• Epilepsy in children can affect various physiological systems.
• Subclinical cardiac alterations may be present in pediatric epilepsy.
• Understanding these changes is crucial for comprehensive patient care.

Purpose of the Study:

• To evaluate subclinical alterations in cardiac conduction and ventricular repolarization in children with epilepsy.
• To compare corrected QT dispersion (QTcd), Tpeak-Tend (Tp-e) interval, Tp-e-based ratios, and P-wave dispersion (PWD) between pediatric epilepsy patients and healthy controls.
• To explore electrophysiological differences between electrocardiographic recordings from emergency department (ED) and interictal outpatient evaluations.

Main Methods:

• A prospective case-control study involving 149 children with epilepsy and 75 healthy controls.
• Standardized 12-lead electrocardiography was performed.
• Key ECG parameters analyzed included QTcd, Tp-e interval, Tp-e/QTc ratio, and PWD.

Main Results:

• Children with epilepsy exhibited significantly longer PR intervals, higher PWD, and increased QTc, QTcd, Tp-e interval, and Tp-e/QTc ratio compared to controls.
• Differences in conduction and repolarization parameters were observed between ED and outpatient recordings.
• Antiseizure medication therapy did not show a significant association with ECG parameters.

Conclusions:

• Children with epilepsy demonstrate subclinical atrial conduction and ventricular repolarization differences.
• These findings may indicate autonomic or cardiac electrical modulation linked to epilepsy.
• Further prospective studies are needed to correlate these electrophysiological findings with clinical cardiac outcomes.