Probability of detection of clinical seizures using heart rate changes

• Heart rate changes are subject to various influences including seizures.
• Heart rate changes are used for seizure detection.
• Seizure detection probability using heart rate was investigated as a function of various factors.
• Seizure detection probability using heart rate changes is multifactorial.
• Knowledge of the factors influencing cardiac-based seizure detection will enhance its clinical applicability.

PurposeHeart rate-based seizure detection is a viable complement or alternative to ECoG/EEG. This study investigates the role of various biological factors on the probability of clinical seizure detection using heart rate.MethodsRegression models were applied to 266 clinical seizures recorded from 72 subjects to investigate if factors such as age, gender, years with epilepsy, etiology, seizure site origin, seizure class, and data collection centers, among others, shape the probability of EKG-based seizure detection.ResultsClinical seizure detection probability based on heart rate changes, is significantly (p < 0.001) shaped by patients’ age and gender, seizure class, and years with epilepsy. The probability of detecting clinical seizures (>0.8 in the majority of subjects) using heart rate is highest for complex partial seizures, increases with a patient's years with epilepsy, is lower for females than for males and is unrelated to the side of hemisphere origin.ConclusionClinical seizure detection probability using heart rate is multi-factorially dependent and sufficiently high (>0.8) in most cases to be clinically useful. Knowledge of the role that these factors play in shaping said probability will enhance its applicability and usefulness. Heart rate is a reliable and practical signal for extra-cerebral detection of clinical seizures originating from or spreading to central autonomic network structures.