. 2024 Jul 20;27:100696. doi: 10.1016/j.ebr.2024.100696

Table 2.

Criteria for the Epileptic Heart Syndrome.^*

•
Chronic Epilepsy with or without Drug-Resistance
- o
  Based on ILAE standard diagnostic criteria
•
Myocardial Injury and Arrhythmia Risk on EKG
- o
  Clinical signs and symptoms such as exercise intolerance, chest pain, irregular pulse and palpitations
- o
  Atrial and/or ventricular arrhythmias
- o
  P waves >2.5 mm tall and/or >110 ms wide may indicate atrial enlargement
- o
  Q waves—indicator of prior myocardial infarction
- o
  QRS complex >150 ms wide may indicate conduction abnormalities and electrical dyssynchrony
- o
  Severe QT interval prolongation (>450 ms in men, >470 ms in women) may indicate repolarization abnormalities or antiseizure medication use
- o
  ST-segment depression or elevation
- o
  T-wave alternans ≥47 µV
•
Altered Autonomic Tone as Assessed by HRV Measures
- o
  rMSSD <27 ± 12 ms
- o
  LF/HF ratio >1.5–2.0
•
Diastolic Dysfunction on Echocardiography
- o
  Increased left ventricle stiffness (β constant)
- o
  Elevated left ventricular diastolic filling pressure (mmHg)
- o
  Increased left atrial volume (ml)
•
Hyperlipidemia and Accelerated Atherosclerosis
- o
  Triglycerides >149 mg/dl; high-density lipoprotein (HDL) <40 mg/dl male, <50 mg/dl female
- o
  Consider ultrasound measurement of carotid intima media thickness

Note: ILAE = International League Against Epilepsy.

Requires the presence of chronic epilepsy and any two other criteria.