• Antonio Siniscalchi, Francesco Scaglione, Enzo Sanzaro, Francesco Iemolo, Giorgio Albertini, Gianluca Quirino, Maria Teresa Manes, Santo Gratteri, Nicola Biagio Mercuri, Giovambattista De Sarro, and Luca Gallelli.
• Department of Neurology, "Annunziata" Hospital, Cosenza, Italy.
• Clin Drug Investig. 2014 Dec 1;34(12):879-86.

Background And ObjectivesSudden unexplained/unexpected death (SUDEP) is related to high mortality in patients with epilepsy. The prolongation of QT interval, involved in cardiac arrhythmia-related SUDEP, may be precipitated by antiepileptic drugs (AEDs). In this study, we evaluated the effects of phenobarbital and levetiracetam on PR-QTc intervals in patients with post-stroke seizures.MethodsWe performed an open-label, parallel group, prospective, multicenter study between June 2009 and December 2013 in patients older than 18 years of age with a clinical diagnosis of post-stroke seizure and treated with phenobarbital or levetiracetam. In order to exclude a role of cerebral post-stroke injury on modulation of PR and QTc intervals, patients with cerebral post-stroke injury and without seizures were also enrolled as controls.ResultsInterictal electrocardiography analysis revealed no significant difference in PR interval between patients treated with an AED (n = 49) and control patients (n = 50) (181.25 ± 12.05 vs. 182.4 ± 10.3 ms; p > 0.05). In contrast, a significantly longer QTc interval was recorded in patients treated with an AED compared with control patients (441.2 ± 56.6 vs. 396.8 ± 49.3 ms; p < 0.01). Patients treated with phenobarbital showed a significantly longer QTc interval than patients treated with levetiracetam (460.0 ± 57.2 vs. 421.5 ± 50.1 ms; p < 0.05).ConclusionsThe study reported that in patients with late post-stroke seizures, phenobarbital prolonged QTc interval more so than levetiracetam.

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