| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 6014725 | Epilepsy & Behavior | 2011 | 6 Pages |
ObjectiveThe goal of the study described here was to evaluate interictal heart rate variability (HRV) in young patients with epilepsy, a patient population in whom sudden unexpected death in epilepsy (SUDEP) is known to be more common.MethodsTwenty-four-hour ambulatory ECG Holter recordings of 37 patients (15-40Â years old) and 32 healthy controls were compared.ResultsAll of the time domain indices (SDNN, SDANN, RMSSD, and HRV triangular index) were significantly suppressed (PÂ <Â 0.001), and there was a marked reduction in parasympathetic tone (reduced HFnu,PÂ <Â 0.001) and an increase in sympathetic tone (increased LFnu and LF/HF ratio, PÂ <Â 0.001) in the patient group. Stepwise linear regression analysis revealed that polytherapy and epilepsy duration >Â 10Â years were independent variables associated with a reduction in SDNN.ConclusionOur data suggest that the major determinants of suppressed SDNN are polytherapy and epilepsy duration >Â 10Â years. Analysis of spectral measures of frequency domain indices suggests that an increased sympathetic tone in association with a decreased parasympathetic tone may constitute the mechanism underlying SUDEP in young people with epilepsy.
Research Highlights⺠A study executed in a high risk population: young adult epileptics. ⺠European Task Force guidelines suggest 24 h ECG recordings. ⺠Possible mechanisms for sudden unexplained death in epileptics were discussed. ⺠Two major risk factors were proposed.
