ArticleHeart rhythm2022
QT prolongation in patients with index evaluation for seizure or epilepsy is predictive of all-cause mortality.
Article in Heart rhythm, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Electrocardiographic abnormalities in epilepsy: analysis of cardiac conduction patterns and SUDEP Risk.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Effect Modification of Alcohol Use on Epilepsy: NHIS Longitudinal Study.Biomedicines · 2026Article
- Development and Validation of a Model to Predict Secondary Arrhythmia in Patients With Epilepsy.CNS neuroscience & therapeutics · 2025Article
- Intersection of epilepsy and cardiac health: Insights from electrocardiography and syndromic associations.Epilepsia · 2025Review
- Knock-in Kcnh2 rabbit model of long QT syndrome type-2, epilepsy, and sudden death.Journal of translational medicine · 2025Article
- Sudden unexpected death in epilepsy: respiratory vs. cardiac contributions.Cardiovascular research · 2025Review
- Gelastic spells in Angelman Syndrome, when laughter isn't funny.Epilepsy & behavior reports · 2025Article
- Management recommendations to reduce cardiac risk in chronic epilepsy.Epilepsy & behavior reports · 2025Review
- Evaluating the Incidence of Seizures and Its Relationship With Blood Glucose Levels in Tramadol Poisoning Patients Admitted to Imam Reza Hospital in Mashhad (Iran) From 2019 to 2020.Journal of toxicology · 2025Article
- Cardiac abnormalities and repolarization variability in epilepsy: influence of antiseizure medications and treatment response.Frontiers in cardiovascular medicine · 2025Article
- Article
- The brain-heart connection: Value of concurrent ECG and EEG recordings in epilepsy management.Epilepsy & behavior reports · 2024Review
- The Epileptic Heart Syndrome: Epidemiology, pathophysiology and clinical detection.Epilepsy & behavior reports · 2024Article
- Sudden death in epilepsy: the overlap between cardiac and neurological factors.Brain communications · 2024Review
- Epilepsy and long-term risk of arrhythmias.European heart journal · 2023Article
- Sudden unexpected death in epilepsy.Current opinion in neurology · 2022Review
- Sudden death across brain and heart: cardio-cerebral ion channel dysfunction as a potential risk-modifying mechanism linking epilepsy and long QT syndrome.Frontiers in neurologyReview
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13 authors.
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Abstract
backgroundRefractory epilepsy confers a considerable lifetime risk of sudden unexplained death in epilepsy (SUDEP). Mechanisms may overlap with sudden cardiac death (SCD), particularly regarding QTc prolongation. Guidelines in the United States do not mandate the use of electrocardiography (ECG) in diagnostic evaluation of seizures or epilepsy.
objectiveThe purpose of this study was to determine the frequency of ECG use and of QT prolongation, and whether QT prolongation predicts mortality in patients with seizures.
methodsWe performed a retrospective cohort study including all patients seen at Mayo Clinic in Rochester, Minnesota, from January 1, 2000, to July 31, 2015, with index evaluation for seizure or epilepsy. Patients with an ECG were categorized by the presence of a prolonged QT interval with a primary endpoint of all-cause mortality after the 15-year observation period.
resultsOptimal cutoff QT intervals most predictive of mortality were identified. Median age was 40.0 years. An ECG was obtained in 18,222 patients (57.4%). After patients with confounding ECG findings were excluded, primary prolonged QT intervals were seen in 223 cases (1.4%), similar to the general population. Kaplan-Meier analysis demonstrated a significant increase in mortality (Cox hazard ratio [HR] 1.90; 95% confidence interval [CI] 1.76-2.05) for prolonged optimal cutoff QT, maintained after adjustments for age, Charlson comorbidity index, and sex (HR 1.48; 95% CI 1.37-1.59).
conclusionUse of ECG in diagnostic workup of patients with seizures is poor. A prolonged optimal cutoff QTc interval predicts all-cause mortality in patients evaluated for seizure and those diagnosed with epilepsy. We advocate the routine use of a 12-lead ECG at index evaluation in patients with seizure or epilepsy.
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