Can ECG monitoring identify seizures?

• Cardiac and respiratory changes during epileptic seizures
• Cardiorespiratory interactions derived solely from the ECG signal
• Effect of epilepsy on cardiorespiratory interactions
• Cardiorespiratory information improves the detection of generalized seizures

BackgroundSeizures affect the autonomic control of the heart rate and respiration, and changes in these two variables are known to occur during, and even before the EEG onset of the seizure.GoalThis work aims to quantify these changes and use them to identify the ECG onset.MethodsSingle-lead ECG signals were recorded from patients suffering from focal and generalized seizures. Two algorithms are proposed: one quantifies changes in the QRS morphology using principal component analysis, and one assesses cardiorespiratory interactions using phase rectified signal averaging.ResultsPositive predictive values of 86.6% and 77.5% and sensitivities of 100% and 90% were achieved for focal and generalized seizures respectively.ConclusionResults for focal seizures are in accordance with the literature, and detection of generalized seizures is improved after including respiratory information.SignificanceThese findings could improve monitoring systems in epilepsy, and closed-loop techniques that aim to stop seizures.