QT Interval and QT Dispersion Abnormalities in Hospitalized Patients with Epilepsy: A Multi-Lead Electrocardiographic Study

Background Epilepsy is associated with increased premature mortality, including sudden unexpected death in epilepsy (SUDEP), in which cardiac arrhythmias are implicated. Ventricular repolarization abnormalities, particularly QT prolongation and QT dispersion, may contribute to arrhythmogenic risk. however, data remain limited and inconsistent, especially in hospitalized Middle Eastern populations. Methods This retrospective cross-sectional study evaluated QT parameters in 104 hospitalized epilepsy patients admitted between March 2022 and March 2024. Standard 12-lead interictal ECGs were analyzed to measure QT, corrected QT (QTc), mean QTc, QT dispersion (QTd), and corrected QT dispersion (QTcd). Associations between QT parameters and age, sex, epilepsy duration, treatment status, and serum electrolytes were examined. Results QTc prolongation was observed in 28.8% of patients. QTd and QTcd were 52 ± 2 and 63 ± 26 milliseconds (ms) on average. QTd and QTcd exceeding 65 ms were observed in 21.1% and 44.2% of patients respectively. lead I QTc was significantly lower in men (p = 0.013). No significant differences in QT parameters were observed by epilepsy duration or treatment status. Age showed a significant positive correlation solely with mean QTc (r = 0.222, P = 0.024). Among serum electrolytes, only potassium demonstrated a significant inverse correlation with mean QTc (r = − 0.230, P = 0.019). Conclusions High frequencies of increased QT interval, QT dispersion, and arrhythmic and mortality risks were demonstrated in our population. QTc prolongation correlated with female sex (lead-dependent), advanced age and lower physiological levels of potassium, which provides insight into modulators of ventricular repolarization in epilepsy and role of QT markers in arrhythmia risk stratification and SUDEP pathophysiology.