Epilepsy, Antiepileptics Both Linked to Sudden Cardiac Death Risk
the MPR take:
Symptomatic epilepsy and use of antiepileptic medications (AEMs) for chronic pain syndromes are associated with an increased risk of sudden cardiac death (SDC), according to new research published in the journal Heart. The case-control study of 926 SCD cases and 9,832 controls included the epilepsy categories symptomatic epilepsy (seizure <2 years before SCD) and stable epilepsy (no seizure <2 years before SCD). A threefold increase in SCD risk was observed in symptomatic epilepsy patients compared to the general population; there was no evidence of an increased SCD risk in patients with stable epilepsy. AEM use was independently associated with increased SCD risk in symptomatic epilepsy and in non-epilepsy patients using AEMs for chronic pain syndromes. Sodium channel blocking AEMSs were linked to increased SCD risk but AEMs without sodium channel blocking properties were not; this indicates that sodium channel blockage may be a contributing factor to the increased SCD risk in AEM users. The authors also suggest that a genetic cause may be a possible underlying mechanism for SCD risk in epilepsy. Patients taking sodium channel blocking AEMs for chronic pain syndromes should be monitored for additional SCD risk factors and patients with poor seizure control evaluated for potential treatment changes.
Methods: We studied SCD cases and age/sex matched controls in a case-control study in a large scale general practitioners' research database (n=478 661 patients). SCD risk for symptomatic epilepsy (seizure <2 years before SCD), stable epilepsy (no seizure <2 years before SCD), and use of AEMs (any indication) was determined.
READ FULL ARTICLE From Heart - BMJ Journals