The ability to assess seizure risk may help provide timely warnings and more personalized treatment plans for people with epilepsy (PWE). ECG changes are commonly observed in epilepsy which make ECG a promising candidate to monitor seizure risk. Most ECG research in this domain has focused on heart rate-related changes. However, several studies have identified a range of other peri-ictal ECG parameter changes that may potentially prove useful for seizure detection and forecasting. Here, we offer a systematic review of ECG changes in epilepsy outside of heart rate. We performed the systematic literature review according to PRISMA guidelines using key words related to ECG, SUDEP and epilepsy. We identified and screened 502 abstracts, read 110 full papers, and included 24 papers in the final review. Our results suggest that PWE may be more prone to cardiac conduction abnormalities than healthy controls. During interictal periods, PWE were more likely to have abnormal QTc intervals, ST segment abnormalities, elevated T Waves, early repolarization (ER), increased P Wave dispersion and PR intervals when compared to controls. Apart from these baseline abnormalities, changes during the pre-ictal and ictal states have been reported, with arrhythmias, QTc prolongation and ST segment changes being the most common. A better understanding of these state-dependent changes may afford less-cumbersome and less-stigmatizing epilepsy monitoring tools in the future.

中文翻译：

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与超出心率的癫痫相关的心电图变化及其在未来癫痫检测和预测方法中的应用

评估癫痫发作风险的能力可能有助于为癫痫患者 (PWE) 提供及时警告和更个性化的治疗计划。ECG 变化在癫痫中很常见，这使 ECG 成为监测癫痫发作风险的有希望的候选者。该领域的大多数心电图研究都集中在与心率相关的变化上。然而，几项研究已经确定了一系列其他围发作期 ECG 参数变化，这些变化可能对癫痫检测和预测有用。在这里，我们对心率以外的​​癫痫的心电图变化进行了系统评价。我们根据 PRISMA 指南使用与 ECG、SUDEP 和癫痫相关的关键词进行了系统的文献回顾。我们确定并筛选了 502 篇摘要，阅读了 110 篇全文，并在最终审查中纳入了 24 篇论文。我们的结果表明 PWE 可能比健康对照更容易出现心脏传导异常。在间歇期，与对照组相比，PWE 更有可能出现 QTc 间期异常、ST 段异常、T 波升高、早期复极 (ER)、P 波离散度和 PR 间期增加。除了这些基线异常之外，还报告了发作前和发作状态期间的变化，其中最常见的是心律失常、QTc 延长和 ST 段变化。更好地了解这些依赖于状态的变化可能会在未来提供不那么麻烦和更少污名化的癫痫监测工具。与对照组相比，早期复极化 (ER)、P 波分散和 PR 间期增加。除了这些基线异常之外，还报告了发作前和发作状态期间的变化，其中最常见的是心律失常、QTc 延长和 ST 段变化。更好地了解这些依赖于状态的变化可能会在未来提供更简单、更少污名化的癫痫监测工具。与对照组相比，早期复极化 (ER)、P 波分散和 PR 间期增加。除了这些基线异常之外，还报告了发作前和发作状态期间的变化，其中最常见的是心律失常、QTc 延长和 ST 段变化。更好地了解这些依赖于状态的变化可能会在未来提供更简单、更少污名化的癫痫监测工具。