Evaluation of the Impact of Epileptic Seizures on Cardiac Electrical Activity Through Postictal Electrocardiography (ECG): an Observational Prospective Study

Objective: Epileptic seizures affecting higher autonomic control centers may disrupt parasympathetic-sympathetic balance, contributing to cardiovascular dysfunction and increased morbidity and mortality.This study aimed to evaluate the impact of epileptic seizures on cardiac electrical activity using post-ictal electrocardiography (ECG).Methods: This prospective cohort study evaluated patients presenting to the emergency department with epileptic seizures.Demographic data, laboratory results, and ECG parameters (heart rate, rhythm, wave durations, and morphologies) were recorded.Patients were categorized as newly diagnosed or known epilepsy cases, with further classification based on antiepileptic drug use.The frequency of ECG abnormalities was analyzed, comparing conduction disturbances between groups.Results: This study included 205 cases of epileptic seizures.Among the patients, 35 (17.1%) were newly diagnosed.Sinus tachycardia was observed in 24.4%, T wave inversion in 30.2%, and first-degree atrioventrikler block in 4.9%.PR interval abnormalities were detected in 7.8% and corrected QT interval (QTc) abnormalities in 10.7%.Prolonged PR interval was more common in newly diagnosed patients (14.3% vs. 2.9%, p=0.036), while the mean QTc interval was shorter in these patients compared to controls (p=0.040).No significant differences were found in tachycardia/bradycardia (p=0.403),ST segment changes (p=0.680),QRS duration (p=0.204), or ECG parameters based on antiepileptic drug use.intensive care unit (ICU) patients had higher leukocyte (p=0.036) and neutrophil counts (p=0.009), with lower pH (p=0.004) and bicarbonate levels (p=0.009). Conclusion:Sinus tachycardia is the most prevalent ECG abnormality in epileptic seizures.Elevated lactate and decreased bicarbonate levels may predict seizure duration and ICU admission.No significant association was found among epilepsy, anti-epileptic drugs, and severe arrhythmias.