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Electrocardiographic features of sudden unexpected death in epilepsy
Author(s) -
Chyou Janice Y.,
Friedman Daniel,
Cerrone Marina,
Slater William,
Guo Yu,
Taupin Daniel,
O'Rourke Sean,
Priori Silvia G.,
Devinsky Orrin
Publication year - 2016
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13411
Subject(s) - epilepsy , sudden death , medicine , cardiology , neuroscience , psychology , psychiatry
Summary Sudden unexpected death in epilepsy ( SUDEP ) is the most common cause of epilepsy‐related mortality. We hypothesized that electrocardiography ( ECG ) features may distinguish SUDEP cases from living subjects with epilepsy. Using a matched case–control design, we compared ECG studies of 12 consecutive cases of SUDEP over 10 years and 22 epilepsy controls matched for age, sex, epilepsy type (focal, generalized, or unknown/mixed type), concomitant antiepileptic, and psychotropic drug classes. Conduction intervals and prevalence of abnormal ventricular conduction diagnosis ( QRS ≥110 msec), abnormal ventricular conduction pattern ( QRS <110 msec, morphology of incomplete right or left bundle branch block or intraventricular conduction delay), early repolarization, and features of inherited cardiac channelopathies were assessed. Abnormal ventricular conduction diagnosis and pattern distinguished SUDEP cases from matched controls. Abnormal ventricular conduction diagnosis was present in two cases and no controls. Abnormal ventricular conduction pattern was more common in cases than controls (58% vs. 18%, p = 0.04). Early repolarization was similarly prevalent in cases and controls, but the overall prevalence exceeded that of published community‐based cohorts.