Abstract 12703: Antiepileptic Medicines is Associated With Brugada-Type ST Elevation in Patients With Epilepsy
Purpose: Some of psychotropic medicines are known to cause ECG changes such as QT prolongation. Because some of antiepileptic medicines have sodium or calcium channel blocking effects, they may lead to manifestation of Brugada-type ST elevation or J-wave like inter-ventricular conduction delay. In the present study, we focused on the patients with epilepsy who have continued to take antiepileptic medicines, and the prevalence of Brugada-type ST elevation was evaluated in their ECG.
Method: The study population consisted of 120 consecutive patients with epilepsy who have continued to take more than one of antiepileptic medicines (carbamazepine 63, phenytoin 43, valproic acid 50, phenobarbital 10 and the others 23 patients) and have analyzable ECG recordings during these therapies. Brugada-type ST elevation was classified into type 1-3 in accordance with the consensus report of Brugada syndrome.
Results: Out of 120 patients, 15 (12.5%) exhibited Brugada-type ST elevation (type 1 6.67%, type2 20.0%, and type3 73.3%), whose incidence was much higher than normal population. When comparing patients with and without Brugada-type ST elevation, the combination of antiepileptic medicines with sodium channel blocking effect (i.e., carbamazepine or phenytoin) was more frequently seen in patients with Brugada-type ST elevation (p=0.016). However, the serum concentrations of these medicines did not show significant difference between patients with and without Brugada-type ST elevation (carbamazepine: 7.93±4.08 vs. 7.20±5.87μg/dl. p=0.836, phenytoin: 12.7±4.12 vs. 15.5±9.52μg/dl. p=0.476) .
Conclusion: The incidence of Brugada-type ST elevation in patients with antiepileptic medicines was much higher than in reported normal population. The ECG changes were more frequently seen by combination therapy of antiepileptic medicines with sodium channel blocking effect.
Author Disclosures: N. Ishizue: None. S. Niwano: None. M. Saitou: None. T. Igarashi: None. T. Fujiishi: None. T. Yoshizawa: None. J. Kishihara: None. M. Murakami: None. H. Fukaya: None. H. Niwano: None. H. Miyaoka: None. J. Ako: None.
- © 2014 by American Heart Association, Inc.