Abstract
Epileptic seizure leads to sudden unexpected death in epilepsy (SUDEP) among affected patients. The causes of SUDEP are still unclear. The aim of this study was to research the effect of epilepsy on myocardial injury and arrhythmias during experimentally induced acute myocardial ischemia. Wistar albino rats were divided into four groups: sham, pentylentetrazole (PTZ) + sham, ischemia, and PTZ + ischemia groups. PTZ (65 mg/kg, ip) was given 2 h before ischemia. Seizure scoring was conducted by evaluating the PTZ-induced behavioral changes in the rats. The left main coronary artery was ligated in anesthetized rats for 30 min. The incidence and the number of ventricular arrhythmias were determined. Histopathological scoring was performed for tissue injury by using a microscope. Seizure scores were not different among the groups (P > 0.05). The incidence and number of ventricular tachycardia (VT) episodes were significantly higher in the PTZ + ischemia group than in the ischemia group (P ˂ 0.05). More prominent myocardial damage was observed in the PTZ + ischemia group than in the other groups (histopathological scores: PTZ + ischemia; 2.5 ± 0.5 versus ischemia; 1.2 ± 0.4, P ˂ 0.05). PTZ-induced seizure in rats increased myocardial injury and the incidence and number of VT episodes in myocardial ischemia. These results reveal that seizure in epilepsy patients may increase ventricular arrhythmia and myocardial injury during heart attack.
Highlights
Epilepsy comprises a group of disorders characterized by seizures and excessive neuronal activity in the brain
The incidence and number of ventricular tachycardia (VT) episodes were significantly higher in the PTZ + ischemia group than in the ischemia group (P 0.05)
PTZ-induced seizure in rats increased myocardial injury and the incidence and number of VT episodes in myocardial ischemia. These results reveal that seizure in epilepsy patients may increase ventricular arrhythmia and myocardial injury during heart attack
Summary
Epilepsy comprises a group of disorders characterized by seizures and excessive neuronal activity in the brain. The death rate in epilepsy patients is 2 or 3 times higher than that in the general population. Death generally occurs suddenly and unexpectedly (as in SUDEP) following an epileptic seizure [1]. It has been suggested that SUDEP may be caused by apnea and hypoxia seen in recurrent epileptic seizures, as well as cardiac arrhythmias, and the loss of autonomic function [2,3,4]. Studies regarding the reasons for SUDEP and the effect of epileptic seizure on myocardial tissue injury and cardiac arrhythmias are mostly based on clinical reports. Tigaran et al reported that ST-segment depression and elevated cardiac troponine levels are signs of ischemia in patients with drug refractory epilepsy [5].
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