Department of Emergency Medicine, Kecioren Training and Research Hospital, Ankara, Turkey.
Acta Neurol Belg. 2020 Apr;120(2):321-327. doi: 10.1007/s13760-019-01182-8. Epub 2019 Jul 11.
The aim of the study is to evaluate the changes in electrocardiographic parameters, including QTc dispersion (QTcd), Tpeak-Tend (Tp-e)/QTc ratio and P-wave dispersion (Pd), during the period without seizure activation in patients, presented to the emergency department (ED) with epileptic seizures. This prospective case-control study was conducted between January 2017 and January 2018. Patients, over 18 years old and presented to the ED with epileptic seizure, were consecutively included in the study. Interictal period ECGs of patients were obtained at least 2 hours after the end of the postictal period. ST-segment changes, QT interval, corrected QT interval (QTc), QTd, Pd, Tp-e, Tp-e dispersion (Tp-ed), Tp-e/QTc ratio and arrhythmias were evaluated in interictal ECGs. A total of 103 epileptic patients and 31 control cases were included in the study. Heart rate, QTc, QTcd, Pd, Tp-ed and Tp-e/QTc ratio were significantly higher in the epilepsy group than in the control group (p < 0.05 for all values). No statistically significant difference in those parameters was observed between the patients with known epilepsy and the patients who had seizure for the first time. There was also no statistically significant difference between patients who had recurrent seizures during the observation period and who did not. The patients with epileptic seizures had increased Pd, QTd, QTcd, Tp-ed and Tpe/QTc ratio during interictal period compared to healthy subjects. These electrocardiographic changes might be associated with an increased risk of dysrhythmia. However, prospective large cohorts with short- and long-term follow-up are needed for clinical reflections.
本研究旨在评估在无癫痫发作激活期患者的心电图参数变化,包括 QTc 离散度(QTcd)、Tp-e 间期/QTc 比值和 P 波离散度(Pd)。这项前瞻性病例对照研究于 2017 年 1 月至 2018 年 1 月期间进行。连续纳入在急诊科就诊的癫痫发作患者,年龄大于 18 岁,且发作后至少 2 小时进行了间发性心电图检查。评估了间发性心电图的 ST 段改变、QT 间期、校正 QT 间期(QTc)、QTcd、Pd、Tp-e、Tp-e 离散度(Tp-ed)、Tp-e/QTc 比值和心律失常。共纳入 103 例癫痫患者和 31 例对照组患者。癫痫组的心率、QTc、QTcd、Pd、Tp-ed 和 Tp-e/QTc 比值均明显高于对照组(所有值 p<0.05)。首次发作和已知癫痫患者间这些参数无统计学差异。在观察期间,有反复发作和无反复发作的患者间也无统计学差异。与健康受试者相比,癫痫发作患者在间发性期的 Pd、QTd、QTcd、Tp-ed 和 Tpe/QTc 比值增加。这些心电图变化可能与心律失常风险增加有关。然而,需要进行具有短期和长期随访的前瞻性大型队列研究以进行临床思考。