SynthesisNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Electrocardiographic abnormalities in epilepsy: analysis of cardiac conduction patterns and SUDEP Risk.
Synthesis in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Cardiac effects of one-year levetiracetam monotherapy in children with genetic generalized epilepsy: a prospective longitudinal study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
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16 authors.
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Abstract
backgroundElectrocardiographic (ECG) abnormalities in epilepsy patients may contribute to sudden unexpected death in epilepsy (SUDEP). This systematic review and meta-analysis evaluated the prevalence of ECG abnormalities in epilepsy patients, their age-specific patterns, and association with mortality risk.
methodsFollowing PRISMA guidelines, we systematically searched major databases through September 2024 for studies reporting ECG findings in epilepsy patients. We analyzed 11 studies (2,775 epilepsy patients, 2,751 non-epileptic subjects) using random-effects models for prevalence rates, mean differences, and conducted age-stratified and mortality analyses.
resultsQRS axis deviation emerged as the most robust epilepsy-associated cardiac abnormality, occurring seven-fold more frequently in epilepsy patients compared to controls (23.1% vs 3.2%, p = 0.033). T wave abnormalities showed significantly higher prevalence in epilepsy patients versus controls (31.2% vs 5.0%, p = 0.039). ST segment changes demonstrated a 3.6-fold increased risk in epilepsy patients (RR: 3.55, 95% CI: 1.36-9.22). Age-stratified analysis revealed prolonged QTc was significantly more common in adults compared to pediatric patients (13.5% vs 2.4%, p = 0.04). Mortality analysis showed no significant differences in basic ECG parameters between deceased and surviving epilepsy patients. Basic cardiac parameters including heart rate, PR interval, and QRS duration remained comparable between epilepsy and control groups.
conclusionsEpilepsy patients exhibit distinct cardiac electrical abnormalities, particularly conduction axis and repolarization changes. However, these retrospective findings with substantial heterogeneity represent potential indicators of electrophysiological instability rather than validated SUDEP biomarkers. Rigorous prospective validation is essential before clinical implementation.
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