The potential for QT prolongation by antiepileptic drugs in children.
Cardiac arrhythmia may be one of the major causes of sudden unexpected death in children with epilepsy. We assessed drug-induced QT prolongation to establish whether the use of antiepileptic drugs contributes to sudden unexpected death. A total of 178 children with epilepsy (93 males and 85 females, with ages ranging from 1 month to 18.9 years; mean age 7.0 +/- 4.1 years) were involved in the study. The QT intervals were manually measured and corrected using Fridericia's formula (QTFc = QT/RR(1/3)). The mean corrected QT interval (QTc) of 152 children on antiepileptic drugs during the study period was 0.40 +/- 0.03 s, and for 26 age-matched, antiepileptic drug-free control patients it was 0.40 +/- 0.03 s. The mean QTc of the children with monotherapy was 0.40 +/- 0.03 s for the valproate group (n = 42), 0.39 +/- 0.02 s for the carbamazepine/oxcarbazepine group (n = 34), and 0.40 +/- 0.02 s for the topiramate group (n = 26), respectively. There was no statistically significant difference among the groups as assessed by analysis of variance. In addition, there was no significant difference between the monotherapy group (n = 109; 0.40 +/- 0.02 s) and the polytherapy group (n = 43; 0.39 +/- 0.03 s). Major antiepileptic drugs may not precipitate prolongation of the QT interval into sudden unexpected death in children with epilepsy, however further studies are required.
Department of Pediatrics, Kyungpook National University Hospital, Joong-gu, Daegu, South Korea.
Soonhak
S
Kwon
Sangbum
S
Lee
Myungchul
M
Hyun
Byung-Ho
BH
Choe
Yeohyang
Y
Kim
Woosaeng
W
Park
Yongkeun
Y
Cho
D000293:Adolescent; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D004341:Drug Evaluation / Q000379:methods; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D012307:Risk Factors
D000927:Anticonvulsants