[Cardiac side effects and ECG changes with lamotrigine?--A clinical study].

Abstract

After a patient treated with lamotrigine (LTG) had suffered from thoracal pain and repolarisation deficiencies in the electrocardiogram (ECG), we prospectively investigated 20 patients with localization-related epilepsies to assess cardiovascular side effects of LTG. During the study, LTG was added to a stable dosage of one to three first line antiepileptic drugs (AED). Physical examinations and ECG recordings were performed regularly. Clinical cardial side effects did not occur. Only in single ECG traces of six patients non specific abnormalities were seen. Only in one patient, the abnormalities (supraventricular extrasystoles and a first grade atrioventricular block) unequivocally appeared initially under LTG. However, in the same patient two later ECG recordings under higher LTG dosages were normal. The statistical analysis of the ventricular activation times did not reveal any significant changes under LTG (p = 0.05) with the exception of an extended PQ time when comparing a patient group before LTG (n = 11) with another patient group under LTG (n = 11). Since this observation was not confirmed by the statistical analysis of a third patient group (n = 10) with ECG data prior to and under LTG, we believe that the statistically significant changes mentioned above were based mainly on structural differences between the patient groups and not on true LTG effects. Our results do not give evidence for an elevated risk of clinically relevant cardial side effects under LTG.