Compared to the general population, people with epilepsy (PWE) have increased risk in cardiac comorbidities. This PhD thesis focused to build a better understanding of the cardiac alterations in epilepsy, that could help improve the clinical management and reduce the risk of cardiac pathology-related mortality in affected individuals. By using animal models of epilepsy and a patient cohort with chronic and drug-resistant epilepsy, I provided a comprehensive characterisation of cardiac structure and function and cardiac risk factors in epilepsy.