Epilepsy Patients may have elevated Risk of Cardiac Arrhythmias

A recent study found increased cardiac arrhythmia risk to stay long term in individuals with epilepsy, specially in people who use carbamazepine and valproic acid. The findings of the study were published in European Heart Journal.

Using UK Biobank data, the research also explores the potential roles of genetics and antiseizure medications (ASMs) in this complex relationship. Encompassing 329,432 participants, the study included 2,699 with epilepsy, was initiated between 2006 and 2010. Using advanced statistical techniques like Cox proportional hazards models and competing risk models, the researchers aimed to determine the association between epilepsy history and the incidence of cardiac arrhythmias over an extended period.

Individuals with epilepsy displayed a staggering 36% increased risk of experiencing any form of cardiac arrhythmia compared to those without the condition. This risk extended to specific arrhythmia subtypes, including atrial fibrillation, where a 26% increased risk was identified. More alarmingly, the risk of other cardiac arrhythmias was found to be 56% higher in epilepsy patients.

Genetic predisposition, assessed using polygenic risk scores (PRS), did not appear to alter these associations. This implies that the link between epilepsy and cardiac arrhythmias might not be significantly influenced by genetic factors alone.

An intriguing aspect of the study was the role of antiseizure medications. Individuals with epilepsy who were taking ASMs, particularly carbamazepine and valproic acid, exhibited a notably heightened risk of cardiac arrhythmias. This correlation was supported by drug target Mendelian randomization (MR) analysis, strengthening the case for the involvement of these medications in cardiac complications.

This study not only opens a new avenue of research but also underscores the importance of a multidisciplinary approach to epilepsy management. Collaboration between neurologists and cardiologists could lead to enhanced patient care, reducing the burden of cardiac complications in those living with epilepsy. As the medical community absorbs these findings, it is hoped that they will translate into more tailored treatment plans, ultimately improving the quality of life for epilepsy patients.

Source:

Wang, J., Huang, P., Yu, Q., Lu, J., Liu, P., Yang, Y., Feng, Z., Cai, J., Yang, G., Yuan, H., Tang, H., & Lu, Y. (2023). Epilepsy and long-term risk of arrhythmias. In European Heart Journal. Oxford University Press (OUP). https://doi.org/10.1093/eurheartj/ehad523