The electrocardiographic changes during seizures in symptomathic epileptic children

Objectives And Aim: Cardiac arrhytmias during epileptic seizures are risk factors for sudden unexpected death in epilepsy (SUDEP). Therefore, it is important to detect cardiac arrhytmias in epileptic seizures. The purpose of present study was to identify cardiac arrhytmias and conduction defects during epileptic seizures in children. Patients And Methods: Fifty patients, 29 female (%52) and 21 male (%) with diagnosis of epilepsy and taking antiepileptic drugs were enrolled. All patients were hospitalized at Karadeniz Technical University, Scholl Of Medicine, Department of Pediatric Norology. Mean age of patients was 7.8±1.7 years (range from 3 months to 16 years). Patients were monitorized and electrocardiografies (ECG) were recorded at rest and during epileptic seizures. Oxigen saturations were measured. 157 ECGs during epileptic seizures and 50 ECGs at rest were examined for arrhytmia and conduction defects. Also, PR duration, QT and corrected QT (QTc) were calculated. Results: Compared to the rest, there was statistically significant difference of heart rate (96±22 versus 136±26, p=0.0001) and QTc (408±29.4 versus 450±26, p=0.0001) during epileptic seizures. While ST segment abnormality was detected only in one patient at rest, during epileptic seizures, four patients with ST segment depression were noted. But this did not reach to the statistical significance. Oxigen saturation was 90% or less in 30 patients. During this time no bradycardia was detected. There was no cardiac arrhytmia at rest, but during epileptic seizures, one patient had a supraventricular tachycardia, the other one had frequent ventricular extrasystoles. Conclusions: Tachycardia is frequently encountered during epileptic seizures. Asystole and bradycardia is rarely noted. Cardiac arrhytmias during epileptic seizures are risk factors for SUDEP. These results should be confirmed by further studies.