The effect of antiepleptic drugs on heart rate, QT distance, TP-E interval and TP-E/QTC ratio in children with epilepsy

The aim of this study is to evaluate the effects of antiepileptic drugs on the autonomic nervous system in terms of the electrical activity of the heart and cardiac arrhythmia tendency by calculating the QTd (QT dispersion) and Tp-e (Tpeak-Tend) interval in electrocardiography, which are considered markers of susceptibility to ventricular arrhythmia in children with epilepsy. 145 patients diagnosed with epilepsy using carbamazepine, valproic acid, levetiracetam and 54 healthy children as the control group were included in the study. Electrocardiograms (ECG) of the patient and control groups were evaluated retrospectively, the effects of the drugs on heart rate, QT interval, Tp-e interval and Tp-e/QTc ratio, the possible differences between the drug groups compared to the control group and the differences in between the drug groups themselves has been examined statistically. A statistically significant difference was found between the drug groups and the control group in terms of QT interval (p=0.031). It was determined that the QT interval of the patients using carbamazepine (343,82±33,33) was statistically significantly higher than the patients using valproic acid (321,81±37,27) (p=0.020). Although many studies are conducted on the ECG changes and underlying cardiac electrophysiological changes observed in pediatric epilepsy, their clinical significance is still not fully known. Our study will be important in terms of clinical use of these markers in the evaluation of arrhytmia tendency in childhood, and also in terms of raising awareness about cardiovascular system (CVS) comorbidities in the follow-up of pediatric patients with epilepsy. Keywords: Epilepsy, Carbamazepine, Valproic Acid, Levetiracetam, ECG, QT İnterval