Does the type of seizure influence heart rate variability changes?
| Autor: | Jorge Pereira, Gonçalo Pestana, João Paulo Cunha, Ricardo Rego, Francisca Sá, Susana Rodrigues, Marta Tavares-Silva, Manuel Campelo, Elisabete Martins, Maria Teresa Faria, Francisco Rocha-Gonçalves, Ana Beatriz Oliveira, Hernâni Gonçalves, Helena Rocha, Roberto Pinto, Duarte Dias |
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| Rok vydání: | 2021 |
| Předmět: |
Cardiac function curve
Adult Male medicine.medical_specialty Adolescent Disease Sudden death Risk Assessment Behavioral Neuroscience Epilepsy Young Adult Heart Rate Seizures Internal medicine Medicine Heart rate variability Humans In patient Sudden Unexpected Death in Epilepsy business.industry Electroencephalography Middle Aged medicine.disease Increased risk Neurology Relative risk Cardiology Female Neurology (clinical) business |
| Zdroj: | Epilepsybehavior : EB. 126 |
| ISSN: | 1525-5069 |
| Popis: | Objective Heart rate variability (HRV), an index of the autonomic cardiac activity, is decreased in patients with epilepsy, and a low HRV is associated with a higher risk of sudden death. Generalized tonic-clonic seizures are one of the most consistent risk factors for SUDEP, but the influence (and relative risk) of each type of seizure on cardiac function is still unknown. Our objective was to assess the impact of the type of seizure (focal to bilateral tonic-clonic seizure – FBTCS – versus non-FBTCS) on periictal HRV, in a group of patients with refractory epilepsy and both types of seizures. Methods We performed a 48-hour Holter recording on 121 patients consecutively admitted to our Epilepsy Monitoring Unit. We only included patients with both FBTCS and non-FBTCS on the Holter recording and selected the first seizure of each type to analyze. To evaluate HRV parameters (AVNN, SDNN, RMSSD, pNN20, LF, HF, and LF/HF), we chose 5-min epochs pre- and postictally. Results We included 14 patients, with a median age of 36 (min–max, 16–55) years and 64% were female. Thirty-six percent had cardiovascular risk factors, but no previously known cardiac disease. In the preictal period, there were no statistically significant differences in HRV parameters, between FBTCS and non-FBTCS. In the postictal period, AVNN, RMSSD, pNN20, LF, and HF were significantly lower, and LF/HF and HR were significantly higher in FBTCS. From preictal to postictal periods, FBTCS elicited a statistically significant rise in HR and LF/HF, and a statistically significant fall in AVNN, RMSSD, pNN20, and HF. Non-FBTCS only caused statistically significant changes in HR (decrease) and AVNN (increase). Significance/conclusion This work emphasizes the greater effect of FBTCS in autonomic cardiac function in patients with refractory epilepsy, compared to other types of seizures, with a significant reduction in vagal tonus, which may be associated with an increased risk of SUDEP. |
| Databáze: | OpenAIRE |
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