Electrocardiogram Abnormalities and Associated Factors Among People with and without Epilepsy Attending the Outpatient Department at Referral Hospitals in Amhara Regional State, Northern Ethiopia, 2022: Institutional-Based Comparative Cross-Sectional Study

Tadegew Adane,1 Mihret Melese,2 Ephrem Tesfaye,3,&ast; Adugnaw Ambelu,2,&ast; Mihret Getnet,2,&ast; Deresse Sinamaw,1,&ast; Dereje Esubalew,4,&ast; Yibeltal Yismaw2 1Department of Biomedical Science, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Biomedical Sciences, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale- Goba, Southeast Ethiopia; 4Department of Biomedical Science, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Tadegew Adane Abebe, Email tadegeada0975@gmail.comBackground: Epilepsy is a brain disease that is associated with electrocardiographic (ECG) abnormalities. However, this evidence is limited in Ethiopia. Studying ECG abnormality in epileptic patients could help minimize the cardiac problems and death of epileptic patients by early screening. This study was aimed to assess electrocardiogram abnormalities and associated factors among people with and without epilepsy at referral hospitals in Amhara Regional State (ARS), northern Ethiopia, 2022.Methods: Institutional-based comparative cross-sectional study was conducted from April 20 to June 20, 2022. Three referral hospitals in ARS were selected by simple random sampling. Epileptic patients were selected by systematic random sampling, and 403 age- and sex-matched participants were selected from attendants of patients in the outpatient department. Interviewer-administered questionnaire and digital electrocardiograph were used for data collection. Data were entered to EpiData version 4.6 and exported to stata version 14 for analysis. Variables with P value < 0.25 in bivariable analysis were entered to multivariable binary logistic regression. Strength of association was determined by adjusted odds ratio with a 95% confidence interval (CI).Results: The prevalence of ECG abnormality was 40.0% (95% CI = 34.7– 46.8) and 29.0% (95% CI = 23.2– 34.3) in epileptic and non-epileptic subjects, respectively. The odds of ECG abnormality was 58% higher among epileptic patients. Divorce, duration of epilepsy, uncontrolled epilepsy, former/current smoker, adequate physical activity, hypertension, and overweight/obesity were associated with ECG abnormality among epileptic patients.Conclusion and Recommendations: The proportion of ECG abnormality was higher among the epileptic than the non-epileptic group. This should be a wake-up call for stakeholders to establish appropriate measurements to reduce cardiac issues of epileptic patients.Keywords: electrocardiographic abnormality, epilepsy, Ethiopia