title: Electrocardiographic features of sudden unexpected death in epilepsy.
abstract: 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.
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York, U.S.A.
authors.forename: Janice Y
authors.initials: JY
authors.lastname: Chyou
authors.affiliation: Division of Epilepsy, Department of Neurology, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Daniel
authors.initials: D
authors.lastname: Friedman
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Marina
authors.initials: M
authors.lastname: Cerrone
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: William
authors.initials: W
authors.lastname: Slater
authors.affiliation: Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Yu
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Medicine, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Daniel
authors.initials: D
authors.lastname: Taupin
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, New York, U.S.A.
authors.forename: Sean
authors.initials: S
authors.lastname: O'Rourke
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York, U.S.A.|Molecular Cardiology, IRCCS Salvatore Maugeri Foundation, Pavia, Italy.|Department of Molecular Medicine, University of Pavia, Italy.
authors.forename: Silvia G
authors.initials: SG
authors.lastname: Priori
authors.affiliation: Division of Epilepsy, Department of Neurology, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D016022:Case-Control Studies; D003645:Death, Sudden; D004562:Electrocardiography; D004827:Epilepsy / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: All epilepsy/seizures; Cardiac; Electrocardiogram; Risk factors in epidemiology; Sudden death