Alteration of cardiac autonomic function in patients with newly diagnosed epilepsy

Abstract

The aim of the study was to determine if heart rate variability (HRV) showed any changes in patients with newly diagnosed epilepsy in comparison with controls. Sixty‐five patients with epilepsy (38 males and 27 females), aged 30–50 years, who had never previously received treatment with antiepileptic drugs were eligible for inclusion in this study. Resting electrocardiogram (ECG) at spontaneous respiration was recorded for 5 min in supine position. Time‐domain analysis, frequency‐domain analysis, and Poincare plot of HRV were recorded from ECG. In time‐domain measures, the square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD) and percentage of consecutive RR intervals that differ by more than 50 msec (pNN50) were significantly less in patients with epilepsy. In frequency‐domain measures, high frequency [(HF) msec2], HF (nu), and low frequency [LF (msec2)] were significantly less in patients with epilepsy while LF (nu) and LF/HF were significantly high in patients with epilepsy. In Poincare plot, standard deviation perpendicular to line of Poincare plot (SD1) and standard deviation along the line of entity in Poincare plot (SD2) were significantly less in patients with epilepsy. Our results suggest that epileptic patients have an impact on the cardiac autonomic function as measured by HRV.

Heart rate variability in epilepsy: A potential biomarker of sudden unexpected death in epilepsy risk

“…Hypothetical model of autonomic “second hit” sudden unexpected death in epilepsy (SUDEP) mechanism. Diurnal variation in heart rate variability (HRV) is based on data from this study as well as previous studies . HRV is lower in patients with epilepsy (blue line) than healthy controls (orange line) during the waking hours and then increases well above the healthy control level at nighttime.…”

“…Lower HRV was originally shown to be predictive of mortality in cardiac and elderly populations and has more recently become a topic of interest in epilepsy. Interictal HRV is lower in individuals with epilepsy, including those who are newly diagnosed and drug naive . However, the pattern of dysregulation is not as simple as a uniform decrease across sleep and wakefulness.…”

“…Interictal HRV is lower in individuals with epilepsy, including those who are newly diagnosed and drug naive. 15,16 However, the pattern of dysregulation is not as simple as a uniform decrease across sleep and wakefulness. A recent study found that people with generalized epilepsy had enhanced increase in HRV, reflecting parasympathetic tone, in sleep compared to healthy controls.…”

Increased cardiac stiffness is associated with autonomic dysfunction in patients with temporal lobe epilepsy

“…We found an association between autonomic dysfunction and left ventricle stiffness. Autonomic dysfunction is prevalent in PWE and also in patients with heart failure with preserved ejection fraction (HFpEF) . We recently demonstrated that the percentage achieved of the predicted peak heart rate and chronotropic index was related to age of onset of epilepsy and number of monthly bilateral tonic–clonic seizures .…”

“…People with epilepsy (PWE) have an increased risk of sudden unexpected death in epilepsy (SUDEP) compared to the general population, and SUDEP is responsible for up to 15% of all epilepsy‐related deaths . Interictal autonomic dysfunction has been associated with epilepsy …”