Abstracts

Rationale: Patients with epilepsy are at risk of sudden unexpected death. Cardiac arrhythmias have been postulated as a cause, but it is unknown. Whereas, early repolarization (ER) in inferior/lateral leads on standard ECG increases the risk of arrhythmic death. We aimed to investigate the prevalence and features of ER and assess the potential risk of lethal arrhythmia in epilepsy patients. Methods: We assessed J-point elevation and the ST-segment morphology after ER in 320 epilepsy patients (3112 years, 174 males) and compared with those of the 150 age- and gender-matched control subjects. ER was defined as J-point elevation >0.1mV in ?-2 contiguous inferior or lateral leads. ST-segment morphology after ER was classified as horizontal/descending or rapidly ascending/upsloping pattern. Results: Presence of ERs in epilepsy patients showed higher incidence than in controls (26% vs. 13%, P < 0.001). This observation was significantly higher in the inferior leads (19% vs. 8%, respectively; P < 0.001), but not in the lateral leads. Furthermore, J-point elevation >0.2mV in inferior leads was also more frequent in epilepsy patients than controls (4% vs 1%, P = 0.023). Regarding ST-segment morphology after ER, horizontal/descending pattern was more predominant in epilepsy patients than control subjects. In terms of classification of epilepsy, left temporal lobe epilepsy had significantly higher prevalence of ER compared with the other epilepsy. Conclusions: Among patients with epilepsy, there is higher prevalence of early repolarization, especially in inferior leads and high amplitude of J-point elevation. Funding: None.