QT INTERVAL IN TEMPORAL LOBE EPILEPSY VERSUS NON TEMPORAL LOBE EPILEPSY

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed A Gaber ◽  
Yousry A Abdelhamed ◽  
Mona M Wahid Eldin ◽  
Islam M Bastawy ◽  
Maram S Nasef
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Qt Interval ◽  
Case Series ◽  
Electrode Placement ◽  
Interval Prolongation ◽  
Temporal Epilepsy ◽  
Qt Interval Prolongation ◽  
Significant Prolongation ◽  
Significant Difference

Abstract Introduction Background SUDEP is leading cause of mortality in patients with chronic refractory epilepsy. Despite several epidemiological studies, case series , monitored and witnessed SUDEP the exact mechanism is not proposed Objective This work was carried out to assess QT interval prolongation in epilepsy and whether there’s a difference in QT interval prolongation between temporal epilepsy and non-temporal epilepsy. Patients and methods This study was conducted on 100 patients, 50 aged and sex matched healthy controls who underwent a prolonged (6 to 24 hours) 22 channel computerized EEG monitor with 10-20 system electrode placement and 12 lead electrocardiogram (25 millisecond speed). QT, QTd and QTc using Bazzet’s formulae were calculated. Results The results showed statistically significant difference prolongation of QT interval in epilepsy particularly temporal lobe epilepsy. Conclusion Significant prolongation of QT interval in epilepsy patients (11% suffered pathological prolonged QT). Marked prolongation of QTc and QTd in temporal lobe epilepsy over non temporal group.

scholarly journals Experience with Hydroxychloroquine and Azithromycin in the COVID-19 Pandemic: Implications for QT Interval Monitoring

2020 ◽  
Author(s):  
Archana Ramireddy ◽  
Harpriya Chugh ◽  
Kyndaron Reinier ◽  
Joseph Ebinger ◽  
Eunice Park ◽  
...  
Keyword(s):  
Qt Interval ◽  
Case Series ◽  
Torsades De Pointes ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Qtc Prolongation ◽  
Qt Interval Prolongation ◽  
Significant Prolongation ◽  
Risk Indices ◽  
Increase Risk

ABSTRACTBackgroundDespite a paucity of clinical evidence, hydroxychloroquine and azithromycin are being administered widely to patients with verified or suspected COVID-19. Both drugs may increase risk of lethal arrhythmias associated with QT interval prolongation.MethodsWe performed a case series of COVID-19 positive/suspected patients admitted between 2/1/2020 and 4/4/2020 who were treated with azithromycin, hydroxychloroquine or a combination. We evaluated baseline and post-medication QT interval (QTc, Bazett’s) using 12-lead ECGs. Critical QTc prolongation was defined as: a) maximum QTc ≥500 ms (if QRS <120 ms) or QTc ≥550 (if QRS ≥120 ms) and b) increased QTc of ≥60 ms. Tisdale score and Elixhauser comorbidity index were calculated.ResultsOf 490 COVID-19 positive/suspected patients, 314 (64%) received either/both drugs, and 98 (73 COVID-19 positive, 25 suspected) met study criteria (age 62±17 yrs, 61% male). Azithromycin was prescribed in 28%, hydroxychloroquine in 10%, and both in 62%. Baseline mean QTc was 448±29 ms and increased to 459±36ms (p=0.005) with medications. Significant prolongation was observed only in men (18±43 ms vs -0.2±28 ms in women, p=0.02). 12% of patients reached critical QTc prolongation. In a multivariable logistic regression, age, sex, Tisdale score, Elixhauser score, and baseline QTc were not associated with critical QTc prolongation (p>0.14). Changes in QTc were highest with the combination compared to either drug, with many-fold greater prolongation with the combination vs. azithromycin alone (17±39 vs. 0.5±40 ms, p=0.07). No patients manifested torsades de pointes.ConclusionsOverall, 12% of patients manifested critical QTc interval prolongation, and traditional risk indices failed to flag these patients. With the drug combination, QTc prolongation was several-fold higher compared to azithromycin alone. The balance between uncertain benefit and potential risk when treating COVID-19 patients with these drugs should be carefully assessed prior to use.

scholarly journals Depressive disorders in patients with pharmaco-resistant mesial temporal lobe epilepsy

2017 ◽  
Vol 46 (2) ◽  
pp. 752-760 ◽  
Author(s):  
Eleonora Borges Gonçalves ◽  
Tania Aparecida Marchiori de Oliveira Cardoso ◽  
Clarissa Lin Yasuda ◽  
Fernando Cendes
Keyword(s):  
Depressive Disorder ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Depressive Disorders ◽  
Case Series ◽  
Mesial Temporal Lobe Epilepsy ◽  
Psychiatric Interview ◽  
Case Series Study ◽  
Significant Difference ◽  
Mesial Temporal Lobe

Objectives To assess depressive disorders in patients with mesial temporal lobe epilepsy (MTLE) refractory to medical treatment. Methods Adult patients with refractory MTLE completed two questionnaires (Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory (BDI) had a semi-structured psychiatric interview and a high resolution MRI scan. For complete neuropsychiatric diagnosis, as per International Classification of Diseases (ICD-10), the results were combined with clinical history and additional information from the patients’ family. Results Of the 40 patients identified for this case series study which took place from 2008–2012, 31 (77.5%) had a depressive disorder: 14 had dysthymia, 11 had recurrent depressive disorder and 6 had bipolar disorder. Of the nine patients without a firm diagnosis of mood disorder, seven had isolated symptoms of depression or anxiety and two presented with mixed depression/anxiety symptoms. Only 8/31 (25.8%) patients were receiving antidepressant treatment. There was no association between BDI scores and seizure frequency. No significant difference was found between patients with and without depression and the presence or laterality of HA. Conclusions Depressive disorders are common, underdiagnosed and undertreated in patients with refractory MTLE.

scholarly journals Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7 ◽  
Author(s):  
Seyed Parsa Eftekhar ◽  
Sohrab Kazemi ◽  
Mohammad Barary ◽  
Mostafa Javanian ◽  
Soheil Ebrahimpour ◽  
...  
Keyword(s):  
High Risk ◽  
Qt Interval ◽  
Therapy Group ◽  
Torsade De Pointes ◽  
Cardiac Monitoring ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Significant Difference ◽  
The Mean

Background. Hydroxychloroquine with or without azithromycin was one of the common therapies at the beginning of the COVID-19 pandemic. They can prolong QT interval, cause torsade de pointes, and lead to sudden cardiac death. We aimed to assess QT interval prolongation and its risk factors in patients who received hydroxychloroquine with or without azithromycin. Methods. This study was a retrospective cohort study. One hundred seventy-two confirmed COVID-19 patients were included in this study, hospitalized at Babol University of Medical Sciences hospitals between March 5, 2020, and April 3, 2020. Patients were divided into two groups: hydroxychloroquine alone and hydroxychloroquine with azithromycin. Electrocardiograms were used for outcome assessment. Results. 83.1% of patients received hydroxychloroquine plus azithromycin vs. 16.9% of patients who received only hydroxychloroquine. The mean age of patients was 59.2 ± 15.4 .The mean of posttreatment QTc interval in the monotherapy group was shorter than the mean of posttreatment QTc interval in the combination therapy group, but it had no significant statistical difference ( 462.5 ± 43.1 milliseconds vs. 464.3 ± 59.1 milliseconds; p = 0.488 ). Generally, 22.1% of patients had a prolonged QTc interval after treatment. Male gender, or baseline QTc ≥ 450 milliseconds, or high-risk Tisdale score increased the likelihood of prolonged QTc interval. Due to QTc prolongation, fourteen patients did not continue therapy after four days. Conclusions. Hospitalized patients treated by hydroxychloroquine with or without azithromycin had no significant difference in prolongation of QT interval and outcome. The numbers of patients with prolonged QT intervals in this study emphasize careful cardiac monitoring during therapy, especially in high-risk patients.

scholarly journals Corrected QT interval and QT dispersion in temporal lobe epilepsy

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Maram Samy Nasef ◽  
Ahmed Abdelmonem Gaber ◽  
Yousry Aboelnaga Abdelhamid ◽  
Islam Bastawy ◽  
Salem Taha Abdelhady ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Qt Interval ◽  
Heart Rhythm ◽  
Qt Dispersion ◽  
Control Group ◽  
Temporal Epilepsy ◽  
Corrected Qt Interval ◽  
Patients With Epilepsy ◽  
Age And Sex

Abstract Background Cardiac arrhythmias are expected among patients with epilepsy due to the effect of anti-epileptic drugs. Temporal lobe epilepsy also causes autonomic seizures that may affect heart rhythm. Prolongation of the corrected QT interval and QT dispersion is a risk factor for cardiac arrhythmia. Objectives We aimed to assess corrected QT interval and QT dispersion in patients with epilepsy and if there is a difference between patients with temporal epilepsy versus non-temporal epilepsy. Methods This study was conducted on 100 patients (50 patients with temporal epilepsy and 50 patients with non-temporal epilepsy) and 50 age- and sex-matched healthy controls. They underwent a prolonged (6 to 24 h) 22 channel computerized electroencephalogram monitor with a 10–20 system. QT dispersion, QT interval, and corrected QT interval (using Bazett’s formula) were calculated. Results This study showed significantly higher QT dispersion and corrected QT interval in patients with epilepsy when compared to the age- and sex-matched control group (P < 0.001, P < 0.001). Also, the corrected QT interval and QT dispersion were significantly higher in temporal epilepsy patients when compared to the non-temporal group (P < 0.001, P < 0.001). Conclusion Corrected QT interval and QT dispersion are higher in epileptic patients and more among temporal epilepsy patients in comparison to non-temporal epilepsy patients.

scholarly journals QT Measurement and Heart Rate Correction during Hypoglycemia: Is There a Bias?

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Toke Folke Christensen ◽  
Jette Randløv ◽  
Leif Engmann Kristensen ◽  
Ebbe Eldrup ◽  
Ole Kristian Hejlesen ◽  
...  
Keyword(s):  
Heart Rate ◽  
Qt Interval ◽  
Interval Prolongation ◽  
Qtc Prolongation ◽  
Qt Interval Prolongation ◽  
Significant Prolongation ◽  
Dead In Bed Syndrome ◽  
Measurement Methodology ◽  
Heart Rate Correction

Introduction. Several studies show that hypoglycemia causes QT interval prolongation. The aim of this study was to investigate the effect of QT measurement methodology, heart rate correction, and insulin types during hypoglycemia.Methods. Ten adult subjects with type 1 diabetes had hypoglycemia induced by intravenous injection of two insulin types in a cross-over design. QT measurements were done using the slope-intersect (SI) and manual annotation (MA) methods. Heart rate correction was done using Bazett’s (QTcB) and Fridericia’s (QTcF) formulas.Results. The SI method showed significant prolongation at hypoglycemia for QTcB (42(6) ms;P<.001) and QTcF (35(6) ms;P<.001). The MA method showed prolongation at hypoglycemia for QTcB (7(2) ms,P<.05) but not QTcF. No difference in ECG variables between the types of insulin was observed.Discussion. The method for measuring the QT interval has a significant impact on the prolongation of QT during hypoglycemia. Heart rate correction may also influence the QT during hypoglycemia while the type of insulin is insignificant. Prolongation of QTc in this study did not reach pathologic values suggesting that QTc prolongation cannot fully explain the dead-in-bed syndrome.

N C I D E N C E O F H I G H G R A D E Q T C F P R O L O N G A T I O N A N D I T S M A N A G E M E N T A M O N G P A T I E N T S U N D E R G O I N G T R E A T M E N T F O R D R U G R E S I S T A N T T U B E R C U L O S I S ( D R - T B ) : C A S E S E R I E S .

2021 ◽  
Vol 15 (2s) ◽  
pp. 38-41
Author(s):  
Meseret Asfaw ◽  
Davd Lee Holtzman ◽  
Gene F. Kwan ◽  
lawrence T. Oyewusi ◽  
carole D. Mitnick ◽  
...  
Keyword(s):  
Qt Interval ◽  
Case Series ◽  
New Drugs ◽  
World Health ◽  
High Grade ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Clinically Significant ◽  
Health Organization ◽  
Almost All

Background: The World Health Organization (WHO) has approved the use of two new drugs, namely Bedaquiline (Bdq) and Delamanid (Dlm), for treatment of Drug Resistant Tuberculosis (DR-TB). One of the concerns raised with the use of these drugs was QT-interval prolongation. This condition could be serious and life threatening. Hence, knowing the magnitude and its management is very important. This case series identifies the incidence and discusses the management of clinically significant QT-interval prolongation amongst a cohort of patients who have been on these medicines. Materials and Methods: Patients with reports of high grade QT-Interval prolongation (i.e. Grade-3 and Grade-4) were identified from the cohort of 265 patients enrolled on bedaquiline and/or delamanid and discussion is made on the pattern, severity and management of each cases identified. Results: Only 4 (1.5%) out of all 265 patients enrolled on Bedaquiline and/or Delamanid have developed high grade QT-Interval prolongation. And all are managed without permanent discontinuation of both drugs. Conclusion: The Incidence of clinically significant QTcF-interval prolongation among DR-TB patients taking bedaquiline and /or delamanid in Lesotho is low. And almost all cases can be managed with more frequent Electrocardiogram (ECG) monitoring and management of other possible causes of QT-interval prolongation without the need to stop one or both drugs permanently.

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