Dabrowski Wojciech, Siwicka-Gieroba Dorota, Schlegel Todd T, Robba Chiara, Zaid Sami, Bielacz Magdalena, Jaroszyński Andrzej, Badenes Rafael
Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, 20-954 Lublin, Poland.
Department of Molecular Medicine and Surgery, Karolinska Institute, SE-171 76 Stockholm, Sweden.
J Clin Med. 2021 Nov 18;10(22):5374. doi: 10.3390/jcm10225374.
Disorders in electroencephalography (EEG) are commonly noted in patients with traumatic brain injury (TBI) and may be associated with electrocardiographic disturbances. Electrographic seizures (ESz) are the most common features in these patients. This study aimed to explore the relationship between ESz and possible changes in QTc interval and spatial QRS-T angle both during ESz and after ESz resolution.
Adult patients with TBI were studied. Surface 12-lead ECGs were recorded using a Cardiax device during ESz events and 15 min after their effective suppression using barbiturate infusion. The ESz events were diagnosed using Masimo Root or bispectral index (BIS) devices.
Of the 348 patients considered for possible inclusion, ESz were noted in 72, with ECG being recorded in 21. Prolonged QTc was noted during ESz but significantly ameliorated after ESz suppression (540.19 ± 60.68 ms vs. 478.67 ± 38.52 ms, < 0.001). The spatial QRS-T angle was comparable during ESz and after treatment. Regional cerebral oximetry increased following ESz suppression (from 58.4% ± 6.2 to 60.5% ± 4.2 ( < 0.01) and from 58.2% ± 7.2 to 60.8% ± 4.8 ( < 0.05) in the left and right hemispheres, respectively).
QTc interval prolongation occurs during ESz events in TBI patients but both it and regional cerebral oximetry are improved after suppression of seizures.
脑外伤（TBI）患者常出现脑电图（EEG）紊乱，且可能与心电图异常有关。脑电图癫痫发作（ESz）是这些患者最常见的特征。本研究旨在探讨ESz与ESz发作期间及发作终止后QTc间期和空间QRS-T角可能变化之间的关系。
对成年TBI患者进行研究。在ESz发作期间，使用Cardiax设备记录体表12导联心电图，并在使用巴比妥酸盐输注有效抑制ESz发作后15分钟记录。使用Masimo Root或脑电双频指数（BIS）设备诊断ESz发作。
在348名可能纳入研究的患者中，72名出现ESz，其中21名记录了心电图。ESz发作期间QTc延长，但在ESz抑制后显著改善（540.19±60.68毫秒对478.67±38.52毫秒，<0.001）。ESz发作期间和治疗后的空间QRS-T角相当。ESz抑制后局部脑血氧饱和度增加（左半球从58.4%±6.2增加到60.5%±4.2（<0.01），右半球从58.2%±7.2增加到60.8%±4.8（<0.05））。
TBI患者在ESz发作期间出现QTc间期延长，但在癫痫发作抑制后QTc间期和局部脑血氧饱和度均得到改善。
