Measuring vagal activity in postictal bradycardia

Andrew C Schomer; Valentina Baljak; Morgan Lynch; Matthew Clark; Jaideep Kapur

doi:10.1016/j.yebeh.2023.109148

Measuring vagal activity in postictal bradycardia

Epilepsy Behav. 2023 Apr:141:109148. doi: 10.1016/j.yebeh.2023.109148. Epub 2023 Mar 10.

Authors

Andrew C Schomer¹, Valentina Baljak², Morgan Lynch³, Matthew Clark⁴, Jaideep Kapur³

Affiliations

¹ Department of Neurology, University of Virginia, Charlottesville, VA, USA. Electronic address: acs8bd@virginia.edu.
² University of Virginia Health System, Charlottesville, VA, USA.
³ Department of Neurology, University of Virginia, Charlottesville, VA, USA.
⁴ Center for Advanced Medical Analytics, University of Virginia, Charlottesville, VA, USA; Advanced Medical Predictive Devices, Diagnostics and Displays Inc., Charlottesville, VA, USA.

PMID: 36907083
DOI: 10.1016/j.yebeh.2023.109148

Abstract

Alterations to cardiac electrical conduction are some of the most frequently observed systemic complications of seizures, with autonomic dysregulation cited as the principal driver for these alterations. In this prospective study, we use 6-lead continuous ECG monitoring in hospitalized patients with epilepsy to trend heart rate patterns in the postictal period. A total of 117 seizures in 45 patients met the criteria for analysis. There was a postictal heart rate increase of 61% (n = 72 seizures), and a decline in heart rate (deceleration) following 38.5% (n = 45). Using 6-lead ECGs for waveform analysis revealed that there was PR prolongation accompanying those seizures that were associated with postictal bradycardia.

Keywords: Epilepsy; Heart rate; PR prolongation; SUDEP; Vagal.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Bradycardia* / complications
Electrocardiography
Electroencephalography / adverse effects
Epilepsy* / complications
Heart Rate / physiology
Humans
Prospective Studies
Seizures / complications

Abstract

Publication types

MeSH terms

Grants and funding