Effect of levetiracetam on cardiac repolarization in children with epilepsy

Abstract

Introduction: Epileptic discharges occurring during seizure may affect many systems in the ictal, postictal, and interictal periods. Autonomic dysfunction and its negative impacts on the heart may cause life-threatening clinical manifestations, cardiac arrhythmias, and sudden cardiac death in epileptic patients. This study investigated the impact of levetiracetam (LEV) therapy on cardiac electrical activity in children with epilepsy.

Material and methods: Our study included a total of 120 cases, comprising 40 newly diagnosed epilepsy patients, 40 epilepsy patients who had been receiving LEV therapy for at least 6 months, and 40 healthy individuals. Age at diagnosis, duration of LEV treatment, and familial history of cardiac disease were recorded in a standardized form. Electrocardiogram (ECG) parameters were calculated for all cases, echocardiography (ECHO) findings were noted, and the obtained data were compared using statistical methods.

Results: A comparison of the ECG parameters showed that the Tpeak-Tend (Tp-e) interval, and the Tp-e/QT dispersion (QTd) and Tp-e/QTc dispersion (QTcd) ratios, of the newly diagnosed epilepsy patients were statistically significantly increased compared with the other two groups (p = <0.001, p = 0.001, and p = 0.007, respectively). There were no statistically significant differences between the three groups in terms of QTd and QTcd.

Discussion: The repolarization differences in children with newly diagnosed epilepsy may have reflected early subclinical findings associated with the disease. We concluded that LEV monotherapy may make a positive contribution to early repolarization differences.

Keywords: Childhood epilepsy; Levetiracetam; QT dispersion; Tp–e interval.