Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy
Epilepsy patients may have an impaired autonomic cardiac control, which has been associated with an increased incidence of sudden unexpected death among people with epilepsy (SUDEP). The risk of SUDEP is particularly high among epilepsy surgery candidates with refractory epilepsy. This risk seems to...
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| Veröffentlicht in: | Neurology 2005-10, Vol.65 (7), p.1021-1025 |
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| description | Epilepsy patients may have an impaired autonomic cardiac control, which has been associated with an increased incidence of sudden unexpected death among people with epilepsy (SUDEP). The risk of SUDEP is particularly high among epilepsy surgery candidates with refractory epilepsy. This risk seems to be reduced after successful surgery but whether this is an effect of surgery or reflects pre-existing differences between good and poor responders is under debate.
We used spectral analysis to analyze prospectively heart rate variability (HRV) preoperatively in 21 consecutive patients with temporal lobe epilepsy who were planned for epilepsy surgery. The presurgical HRV based on ambulatory 24 hours EKG recordings was analyzed in relation to seizure control at 1 year after surgery.
Patients had significantly lower SD of RR-intervals, total power, very low frequency power and low frequency power than matched healthy controls. Patients with good outcome of surgery (Engel class I; n = 11) did not differ from their controls while those with poor outcome (Engel class II-IV; n = 10) had significantly lower power in all domains than those with a favorable outcome.
Measurements of heart rate variability preoperatively indicate that patients with a poor outcome of surgery have a more pronounced impairment of sympathetic as well as parasympathetic cardiac control than those with good outcome. Reduced heart rate variability may be associated with an increased risk of sudden unexpected death among people with epilepsy (SUDEP). Good surgery candidates may a priori have a lower risk of SUDEP. |
| doi_str_mv | 10.1212/01.wnl.0000181368.50750.1c |
| format | Article |
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We used spectral analysis to analyze prospectively heart rate variability (HRV) preoperatively in 21 consecutive patients with temporal lobe epilepsy who were planned for epilepsy surgery. The presurgical HRV based on ambulatory 24 hours EKG recordings was analyzed in relation to seizure control at 1 year after surgery.
Patients had significantly lower SD of RR-intervals, total power, very low frequency power and low frequency power than matched healthy controls. Patients with good outcome of surgery (Engel class I; n = 11) did not differ from their controls while those with poor outcome (Engel class II-IV; n = 10) had significantly lower power in all domains than those with a favorable outcome.
Measurements of heart rate variability preoperatively indicate that patients with a poor outcome of surgery have a more pronounced impairment of sympathetic as well as parasympathetic cardiac control than those with good outcome. Reduced heart rate variability may be associated with an increased risk of sudden unexpected death among people with epilepsy (SUDEP). Good surgery candidates may a priori have a lower risk of SUDEP.</description><identifier>ISSN: 0028-3878</identifier><identifier>ISSN: 1526-632X</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/01.wnl.0000181368.50750.1c</identifier><identifier>PMID: 16217053</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - mortality ; Arrhythmias, Cardiac - physiopathology ; Autonomic Nervous System Diseases - diagnosis ; Autonomic Nervous System Diseases - mortality ; Autonomic Nervous System Diseases - physiopathology ; Biological and medical sciences ; Causality ; Death, Sudden, Cardiac - etiology ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Electrocardiography ; Epilepsy - mortality ; Epilepsy - physiopathology ; Epilepsy - surgery ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Heart - innervation ; Heart - physiopathology ; Heart Rate - physiology ; Medical sciences ; Medicin och hälsovetenskap ; Nervous system (semeiology, syndromes) ; Neurology ; Neurosurgical Procedures - adverse effects ; Neurosurgical Procedures - statistics & numerical data ; Parasympathetic Nervous System - physiopathology ; Patient Selection ; Prospective Studies ; Risk Factors ; Signal Processing, Computer-Assisted ; Sympathetic Nervous System - physiopathology ; Temporal Lobe - physiopathology ; Temporal Lobe - surgery ; Treatment Outcome</subject><ispartof>Neurology, 2005-10, Vol.65 (7), p.1021-1025</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-bd4a903b5ce04b9a575d0d6bb990f620a6cf30b48857d4ccf097160f20e4d53c3</citedby><cites>FETCH-LOGICAL-c470t-bd4a903b5ce04b9a575d0d6bb990f620a6cf30b48857d4ccf097160f20e4d53c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17234145$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16217053$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-77542$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:1933865$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>PERSSON, H</creatorcontrib><creatorcontrib>KUMLIEN, E</creatorcontrib><creatorcontrib>ERICSON, M</creatorcontrib><creatorcontrib>TOMSON, T</creatorcontrib><title>Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy</title><title>Neurology</title><addtitle>Neurology</addtitle><description>Epilepsy patients may have an impaired autonomic cardiac control, which has been associated with an increased incidence of sudden unexpected death among people with epilepsy (SUDEP). The risk of SUDEP is particularly high among epilepsy surgery candidates with refractory epilepsy. This risk seems to be reduced after successful surgery but whether this is an effect of surgery or reflects pre-existing differences between good and poor responders is under debate.
We used spectral analysis to analyze prospectively heart rate variability (HRV) preoperatively in 21 consecutive patients with temporal lobe epilepsy who were planned for epilepsy surgery. The presurgical HRV based on ambulatory 24 hours EKG recordings was analyzed in relation to seizure control at 1 year after surgery.
Patients had significantly lower SD of RR-intervals, total power, very low frequency power and low frequency power than matched healthy controls. Patients with good outcome of surgery (Engel class I; n = 11) did not differ from their controls while those with poor outcome (Engel class II-IV; n = 10) had significantly lower power in all domains than those with a favorable outcome.
Measurements of heart rate variability preoperatively indicate that patients with a poor outcome of surgery have a more pronounced impairment of sympathetic as well as parasympathetic cardiac control than those with good outcome. Reduced heart rate variability may be associated with an increased risk of sudden unexpected death among people with epilepsy (SUDEP). Good surgery candidates may a priori have a lower risk of SUDEP.</description><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - mortality</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Autonomic Nervous System Diseases - diagnosis</subject><subject>Autonomic Nervous System Diseases - mortality</subject><subject>Autonomic Nervous System Diseases - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Causality</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Electrocardiography</subject><subject>Epilepsy - mortality</subject><subject>Epilepsy - physiopathology</subject><subject>Epilepsy - surgery</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Heart - innervation</subject><subject>Heart - physiopathology</subject><subject>Heart Rate - physiology</subject><subject>Medical sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neurosurgical Procedures - adverse effects</subject><subject>Neurosurgical Procedures - statistics & numerical data</subject><subject>Parasympathetic Nervous System - physiopathology</subject><subject>Patient Selection</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Signal Processing, Computer-Assisted</subject><subject>Sympathetic Nervous System - physiopathology</subject><subject>Temporal Lobe - physiopathology</subject><subject>Temporal Lobe - surgery</subject><subject>Treatment Outcome</subject><issn>0028-3878</issn><issn>1526-632X</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxS0EokvhK6AIiZ7IMrbjP-FWtdAiVSoHQHCyHGfSmmbj1E5a7bevywb2VF_smfm9Z9mPkHcU1pRR9hHo-n7o15AX1ZRLvRagRB66Z2RFBZOl5OzXc7ICYLrkWukD8iqlPxkXTNUvyQGVjCoQfEV-f4sYRox28ndYXKONU5ELLO5s9LbxvZ-2hR-KiH1GwlBMoUhzvMK4LcI8ubDB3biL1k0hd3H0PY5p-5q86Gyf8M2yH5IfXz5_PzkvLy7Pvp4cX5SuUjCVTVvZGngjHELV1FYo0UIrm6auoZMMrHQdh6bSWqi2cq6DWlEJHQOsWsEdPyTlzjfd4zg3Zox-Y-PWBOvN0rrJJzRCaUlV5tWT_BhDuxf9E9Kacy1FVn54Unnqfx6bEK_MzXRtlBIVy_jRDs-utzOmyWx8ctj3dsAwJyO11IzXMoOfdqCLIaX8lf-dKZjHxA1QkxM3-8TN38QNfXz-2-WWudlgu5cuEWfg_QLY5GyfcxqcT3tOMV7RSvAHJi-5KA</recordid><startdate>20051011</startdate><enddate>20051011</enddate><creator>PERSSON, H</creator><creator>KUMLIEN, E</creator><creator>ERICSON, M</creator><creator>TOMSON, T</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8V</scope></search><sort><creationdate>20051011</creationdate><title>Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy</title><author>PERSSON, H ; KUMLIEN, E ; ERICSON, M ; TOMSON, T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-bd4a903b5ce04b9a575d0d6bb990f620a6cf30b48857d4ccf097160f20e4d53c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Arrhythmias, Cardiac - diagnosis</topic><topic>Arrhythmias, Cardiac - mortality</topic><topic>Arrhythmias, Cardiac - physiopathology</topic><topic>Autonomic Nervous System Diseases - diagnosis</topic><topic>Autonomic Nervous System Diseases - mortality</topic><topic>Autonomic Nervous System Diseases - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Causality</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Electrocardiography</topic><topic>Epilepsy - mortality</topic><topic>Epilepsy - physiopathology</topic><topic>Epilepsy - surgery</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Heart - innervation</topic><topic>Heart - physiopathology</topic><topic>Heart Rate - physiology</topic><topic>Medical sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neurosurgical Procedures - adverse effects</topic><topic>Neurosurgical Procedures - statistics & numerical data</topic><topic>Parasympathetic Nervous System - physiopathology</topic><topic>Patient Selection</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Signal Processing, Computer-Assisted</topic><topic>Sympathetic Nervous System - physiopathology</topic><topic>Temporal Lobe - physiopathology</topic><topic>Temporal Lobe - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>PERSSON, H</creatorcontrib><creatorcontrib>KUMLIEN, E</creatorcontrib><creatorcontrib>ERICSON, M</creatorcontrib><creatorcontrib>TOMSON, T</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Kungliga Tekniska Högskolan</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>PERSSON, H</au><au>KUMLIEN, E</au><au>ERICSON, M</au><au>TOMSON, T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2005-10-11</date><risdate>2005</risdate><volume>65</volume><issue>7</issue><spage>1021</spage><epage>1025</epage><pages>1021-1025</pages><issn>0028-3878</issn><issn>1526-632X</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>Epilepsy patients may have an impaired autonomic cardiac control, which has been associated with an increased incidence of sudden unexpected death among people with epilepsy (SUDEP). The risk of SUDEP is particularly high among epilepsy surgery candidates with refractory epilepsy. This risk seems to be reduced after successful surgery but whether this is an effect of surgery or reflects pre-existing differences between good and poor responders is under debate.
We used spectral analysis to analyze prospectively heart rate variability (HRV) preoperatively in 21 consecutive patients with temporal lobe epilepsy who were planned for epilepsy surgery. The presurgical HRV based on ambulatory 24 hours EKG recordings was analyzed in relation to seizure control at 1 year after surgery.
Patients had significantly lower SD of RR-intervals, total power, very low frequency power and low frequency power than matched healthy controls. Patients with good outcome of surgery (Engel class I; n = 11) did not differ from their controls while those with poor outcome (Engel class II-IV; n = 10) had significantly lower power in all domains than those with a favorable outcome.
Measurements of heart rate variability preoperatively indicate that patients with a poor outcome of surgery have a more pronounced impairment of sympathetic as well as parasympathetic cardiac control than those with good outcome. Reduced heart rate variability may be associated with an increased risk of sudden unexpected death among people with epilepsy (SUDEP). Good surgery candidates may a priori have a lower risk of SUDEP.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>16217053</pmid><doi>10.1212/01.wnl.0000181368.50750.1c</doi><tpages>5</tpages></addata></record> |
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| subjects | Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - mortality Arrhythmias, Cardiac - physiopathology Autonomic Nervous System Diseases - diagnosis Autonomic Nervous System Diseases - mortality Autonomic Nervous System Diseases - physiopathology Biological and medical sciences Causality Death, Sudden, Cardiac - etiology Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Electrocardiography Epilepsy - mortality Epilepsy - physiopathology Epilepsy - surgery Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Heart - innervation Heart - physiopathology Heart Rate - physiology Medical sciences Medicin och hälsovetenskap Nervous system (semeiology, syndromes) Neurology Neurosurgical Procedures - adverse effects Neurosurgical Procedures - statistics & numerical data Parasympathetic Nervous System - physiopathology Patient Selection Prospective Studies Risk Factors Signal Processing, Computer-Assisted Sympathetic Nervous System - physiopathology Temporal Lobe - physiopathology Temporal Lobe - surgery Treatment Outcome |
| title | Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy |
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