Abstract Objective Data on electrocardiography (ECG) characteristics and their associations with mortality in people with epilepsy from resource‐poor communities remain limited. This study aimed to investigate these associations within a prospective cohort in rural China. Methods We conducted an exploratory analysis within a prospective epilepsy cohort in rural China. Baseline 12‐lead ECG recordings were evaluated using the Minnesota Code and continuous interval measurements. Associations with long‐term mortality, including sudden unexpected death in epilepsy (SUDEP), were assessed using Cox regression models. Results Among 442 participants included in the analysis, 30 deaths occurred during a mean follow‐up of 5.9 years, including 12 SUDEP cases. Half of the participants exhibited at least one baseline ECG abnormality. The most prevalent morphological abnormalities were T‐wave abnormalities (27.3%), arrhythmias (17.5%), and ST‐segment depression (8.2%), with T‐wave abnormalities showing a higher prevalence in older participants. Minnesota Code–defined ventricular conduction defects were associated with an increased risk of SUDEP (adjusted hazard ratio HR 6.53, 95% confidence interval CI 1.42–30.10). High‐amplitude R waves were associated with non–epilepsy‐related mortality (adjusted HR 15.68, 95% CI 3.37–72.92). Significance ECG abnormalities were common in people with epilepsy. Ventricular conduction defects or high‐amplitude R waves were associated with SUDEP or non–epilepsy‐related mortality. ECG could be helpful in recognizing people with epilepsy with high risk of premature death, particularly in resource‐poor settings.
Wang et al. (Sat,) studied this question.