Evaluation of cardiacial influence in epilepsy patients using monotherapy and polyterapy antiepyleptic drug by QTC dispersion

Epilepsy disease is the most common group of neurological diseases known in childhood. Epilepsy seizures can affect central autonomic areas, causing cardiovascular and other autonomic responses in the ictal, interictal and postictal periods. As a result, autonomic dysfunction in the epileptic patients and its negative effects on the heart may cause life-threatening pictures and even cardiac arrhythmias and cardiac sudden death. Sudden cardiac death is blamed for 12-17% of deaths caused by epilepsy. Sudden cardiac death (SUDEP) is more common in epilepsy patients than in other populations and is responsible for 17% of deaths in epilepsy.SUDEP is also one of the leading deaths associated with epilepsy. Due to its high mortality, SUDEP has been remarkable in patients with epilepsy in recent years. Reduced heart rate variability, cardiac repolation changes were associated with cardiac mortality and sudden cardiac death. In electrocardiography (ECG), cardiac repolarization abnormalities are considered as prolongation or shortening in the QT interval or a change in QT dispersion.It has been shown in studies that increased QT dispersion may be useful in predetermining serious dysrhythmia and risk of sudden cardiac death. However, in other studies, there was no significant change in the QT interval, while abnormal ECG findings were found more frequently than the healthy control group. It has been suggested that the use of antiepileptic drugs is also effective on the QTC dispersion and the QT interval. However, epilepsy patients using monotherapy antiepileptic drugs were compared with healthy groups, and the information between the use of more than one antiepileptic drug and ECG change is limited. In our study, we examined the ECG records of epilepsy patients and calculated the QTC dispersions. We compared the QTC dispersions of the patients who received the drug compared to those who did not and the patients who received the drug according to their medication. 96 epilepsy patients admitted to the pediatric neurology outpatient clinic for 1 year and their ECG records were examined. There was no relationship between gender, gestation week, birth type, neonatal intensive care hospitalization history and QTC dispersion. QTC dispersion was found statistically significantly longer in children with epilepsy who had a family history of consanguinity. This situation was remarkable in terms of attention to long QT syndromes with familial transition in epilepsy patients. Compared to patients using antiepileptic drugs and those not using QTC dispersion did not show a significant difference. However, when antiepileptic drug use is longer than 2 years, it is concluded that QTC dispersion is statistically long in QTC dispersion. When the drug groups were examined one by one, no difference was observed in QTC dispersions. It was noteworthy that children diagnosed with epilepsy who received lacosomide therapy, a new generation antiepileptic drug, had a shorter QTC dispersion than other treatments. When patients receiving monotherapy and polytherapy were compared with each other, QTC dispersions were not statistically significant. As a result, QTC dispersion is a simple, accessible and effective method in predicting sudden cardiac death in epilepsy patients. Routine cardiological examinations and ECG are recommended in children diagnosed with epilepsy. Regardless of the medication used in patients using antiepileptic drugs, more attention should be paid to the cardiology examinations.