Epileptic Patients are at Risk of Cardiac Arrhythmias: A Novel Approach using QT-nomogram, Tachogram, and Cardiac Restitution Plots.
BACKGROUND
Sudden death is reported in patients who had a history of epilepsy and some authors believed that is due to cardiac arrhythmias.


OBJECTIVE
This study aimed to predict that the epileptic patients are at risk of serious cardiac arrhythmias by QT-nomogram, tachogram (Lorenz), and cardiac restitution plots.


METHODS
A total number of 71 healthy subjects (Group I) and 64 newly diagnosed epileptic patients (Group II) were recruited from Al-Yarmouk and Baghdad Teaching hospitals in Baghdad from March 2015 to July 2015 and included in this study. The diagnosis of epilepsy achieved clinically, electroencephalograph record and radio-images including computerized tomography and magnetic image resonance. At the time of entry into the study, an electrocardiography (ECG) was done, and the determinants of each ECG record were calculated. The QT-nomogram, tachogram, and cardiac restitution plots were used to identify the patients at risk of cardiac arrhythmias.


RESULTS
Significant prolonged corrected QT corrected (QTc) and JT corrected intervals were observed in female compared with male at age ≥50 years while the TQ interval was significantly prolonged in males of Group II. Eight patients of Group II had a significant pathological prolonged QTc interval compared with undetectable finding in Group I. QT nomogram did not disclose significant findings while the plots of Lorenz and restitution steepness disclose that the patients of Group II were vulnerable to cardiac arrhythmias. Abnormal ECG findings were observed in the age extremities (≤18 years and ≥50 years) in Group II compared with Group I.


CONCLUSIONS
Utilization of QT-nomogram, restitution steepness, and tachogram plots is useful tools for detection subclinical vulnerable epileptic patient with cardiac arrhythmias.
Department of Pharmacology, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq; Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq.
Marwan S
MS
Al-Nimer
Department of Pharmacology, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq.
Sura A
SA
Al-Mahdawi
Al Yarmouk Teaching Hospital, Baghdad, Iraq.
Namir M
NM
Abdullah
Baghdad Teaching Hospital, Baghdad, Iraq.
Akram
A
Al-Mahdawi
Electrocardiogram records; Lorenz plot; QT nomogram; epilepsy; restitution steepness