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 drugs (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.
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 drugs (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, phenobarbitalprolonged QTc interval more so than levetiracetam.
Authors: L Gallelli; G Ferreri; M Colosimo; D Pirritano; M A Flocco; G Pelaia; R Maselli; G B De Sarro Journal: Pharmacol Res Date: 2003-06 Impact factor: 7.658
Authors: L B Goldstein; M R Jones; D B Matchar; L J Edwards; J Hoff; V Chilukuri; S B Armstrong; R D Horner Journal: Stroke Date: 2001-05 Impact factor: 7.914
Authors: L Gallelli; M Nardi; T Prantera; S Barbera; M Raffaele; D Arminio; D Pirritano; M Colosimo; R Maselli; G Pelaia; P De Gregorio; G B De Sarro Journal: Pharmacol Res Date: 2004-03 Impact factor: 7.658
Authors: Richard S Chang; William Cy Leung; Michael Vassallo; Lucy Sykes; Emma Battersby Wood; Joseph Kwan Journal: Cochrane Database Syst Rev Date: 2022-02-07