Effects of Chronic Carbamazepine Treatment on the ECG in Patients with Focal Seizures

• Published in: Clinical drug investigation Vol. 38; no. 9; pp. 845 - 851
• Main Authors: Sathyaprabha, Talakad N., Koot, Laura A. M., Hermans, Ben H. M., Adoor, Meghana, Sinha, Sanjib, Kramer, Boris W., Raju, Trichur R., Satishchandra, Parthasarathy, Delhaas, Tammo
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2018; Springer Nature B.V
• Subjects: Adolescent; Adult; Anticonvulsants - administration & dosage; Arrhythmias, Cardiac - chemically induced; Arrhythmias, Cardiac - physiopathology; Carbamazepine - administration & dosage; Convulsions & seizures; Cross-Sectional Studies; Data analysis; Drug Administration Schedule; Drug dosages; Electrocardiography; Electrocardiography - drug effects; Electrocardiography - methods; Epilepsy; Female; Heart rate; Heart Rate - drug effects; Heart Rate - physiology; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Neurophysiology; Original; Original Research Article; Pharmacology/Toxicology; Pharmacotherapy; Risk factors; Seizures - diagnosis; Seizures - drug therapy; Seizures - physiopathology; Systematic review; Treatment Outcome; Young Adult
• ISSN: 1173-2563; 1179-1918
• DOI: 10.1007/s40261-018-0677-6

Background and Objectives Several mechanisms have been proposed for the sudden unexpected death in epilepsy patients, such as cardiac arrhythmias, a decrease in heart rate variability and the use of anti-epileptic drugs (AEDs). Although carbamazepine is commonly used as an AED, the exact working mechanism of this drug as well as its effect on the heart are not completely understood. The aim of this study was to determine whether chronic carbamazepine therapy in patients with focal seizures and impaired awareness has an effect on the electrocardiogram (ECG). Subjects and Methods This cross-sectional study included 36 patients with focal seizures and impaired awareness treated for 12–32 months with carbamazepine monotherapy and 38 healthy volunteers. A 5-min modified three-electrode chest lead ECG with lead II configuration was recorded using LabChart 7 ECG software module at 1000-Hz sampling frequency. All data analysis was performed using custom-made Matlab 2015b scripts. ECGs of patients and controls were compared with respect to heart rate, time intervals and measures of short- and long-term variation. Results There were no significant differences in heart rate and ECG time intervals between the patient and control groups. Measures on short- and long-term variability also did not show any significant group differences. Conclusion Our study shows that chronic use of carbamazepine as monotherapy does not have any significant effects on ECG time intervals or measures of short- and long-term variability.