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Recent animal studies have revealed that epilepsy secondarily alters the expression of cardiac ion channels alongside abnormal cardiac electrophysiology and remodeling. These molecular findings represent novel evidence for an acquired cardiac channelopathy in epilepsy, distinct from inherited ion channels mutations associated with cardiocerebral phenotypes. Specifically, seizure activity has been shown to alter the <jats:styled-content style=\"fixed-case\">messenger RNA (mRNA)<\/jats:styled-content> and protein expression of voltage\u2010gated sodium channels (Na<jats:sub>v<\/jats:sub>1.1, Na<jats:sub>v<\/jats:sub>1.5), voltage\u2010gated potassium channels (K<jats:sub>v<\/jats:sub>4.2, K<jats:sub>v<\/jats:sub>4.3), sodium\u2010calcium exchangers (<jats:styled-content style=\"fixed-case\">NCX<\/jats:styled-content>1), and nonspecific cation\u2010conducting channels (<jats:styled-content style=\"fixed-case\">HCN<\/jats:styled-content>2, <jats:styled-content style=\"fixed-case\">HCN<\/jats:styled-content>4). The pathophysiology may involve autonomic dysfunction and structural cardiac disease, as both are independently associated with epilepsy and ion channel dysregulation. Indeed, in vivo and in vitro studies of cardiac pathology reveal a complex network of signaling pathways and transcription factors regulating ion channel expression in the setting of sympathetic overactivity, cardiac failure, and hypertrophy. Other mechanisms such as circulating inflammatory mediators or exogenous effects of antiepileptic medications lack evidence. Moreover, an acquired cardiac channelopathy may underlie the electrophysiologic cardiac abnormalities seen in chronic epilepsy, potentially contributing to the increased risk of malignant arrhythmias and sudden death. Therefore, further investigation is necessary to establish whether cardiac ion channel dysregulation similarly occurs in patients with epilepsy, and to characterize any pathogenic relationship with <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/epi.16301","type":"journal-article","created":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T07:24:47Z","timestamp":1564385087000},"page":"1753-1767","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Acquired cardiac channelopathies in epilepsy: Evidence, mechanisms, and clinical significance"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0616-1599","authenticated-orcid":false,"given":"Michael C. 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