Background and Objectives Sudden unexplained/unexpected death (SUDEP) is related to high mortality in patients with epilepsy. The prolongation of QT interval, involved in cardiac arrhythmia-related SUDEP, may be precipitated by antiepileptic dru gs (AEDs). In this study, we evaluated the effects of phenobarbital and levetiracetam on PR–QTc intervals in patients with post-stroke seizures. Methods We performed an open-label, parallel group, prospective, multicenter study between June 2009 and December 2013 in patients older than 18 years of age with a clinical diagnosis of post-stroke seizure and treated with phenobarbital or levetiracetam. In order to exclude a role of cerebral post-stroke injury on modulation of PR and QTc intervals, patients with cerebral post-stroke injury and without seizures were also enrolled as controls. Results Interictal electrocardiography analysis revealed no significant difference in PR interval between patients treated with an AED (n = 49) and control patients (n = 50) (181.25 ± 12.05 vs. 182.4 ± 10.3 ms; p > 0.05). In contrast, a significantly longer QTc interval was recorded in patients treated with an AED compared with control patients (441.2 ± 56.6 vs. 396.8 ± 49.3 ms; p < 0.01). Patients treated with phenobarbital showed a significantly longer QTc interval than patients treated with levetiracetam (460.0 ± 57.2 vs. 421.5 ± 50.1 ms; p < 0.05). Conclusions The study reported that in patients with late post-stroke seizures, phenobarbital prolonged QTc interval more so than levetiracetam.
Effects of Phenobarbital and Levetiracetam on PR and QTc Intervals in Patients with Post-Stroke Seizure / A. Siniscalchi, F. Scaglione, E. Sanzaro, F. Iemolo, G. Albertini, G. Quirino, M. Manes, S. Gratteri, N. Mercuri, G. De Sarro, L. Gallelli. - In: CLINICAL DRUG INVESTIGATION. - ISSN 1173-2563. - 34:12(2014 Dec), pp. 879-886. [10.1007/s40261-014-0243-9]
Effects of Phenobarbital and Levetiracetam on PR and QTc Intervals in Patients with Post-Stroke Seizure
F. ScaglioneSecondo
;
2014
Abstract
Background and Objectives Sudden unexplained/unexpected death (SUDEP) is related to high mortality in patients with epilepsy. The prolongation of QT interval, involved in cardiac arrhythmia-related SUDEP, may be precipitated by antiepileptic dru gs (AEDs). In this study, we evaluated the effects of phenobarbital and levetiracetam on PR–QTc intervals in patients with post-stroke seizures. Methods We performed an open-label, parallel group, prospective, multicenter study between June 2009 and December 2013 in patients older than 18 years of age with a clinical diagnosis of post-stroke seizure and treated with phenobarbital or levetiracetam. In order to exclude a role of cerebral post-stroke injury on modulation of PR and QTc intervals, patients with cerebral post-stroke injury and without seizures were also enrolled as controls. Results Interictal electrocardiography analysis revealed no significant difference in PR interval between patients treated with an AED (n = 49) and control patients (n = 50) (181.25 ± 12.05 vs. 182.4 ± 10.3 ms; p > 0.05). In contrast, a significantly longer QTc interval was recorded in patients treated with an AED compared with control patients (441.2 ± 56.6 vs. 396.8 ± 49.3 ms; p < 0.01). Patients treated with phenobarbital showed a significantly longer QTc interval than patients treated with levetiracetam (460.0 ± 57.2 vs. 421.5 ± 50.1 ms; p < 0.05). Conclusions The study reported that in patients with late post-stroke seizures, phenobarbital prolonged QTc interval more so than levetiracetam.File | Dimensione | Formato | |
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