OBJECTIVE: The goal of this study was to determine if specific measures of heart rate variability (HRV) are associated with the total score on a new seven-item inventory for sudden unexplained death in epilepsy (SUDEP). METHODS:Nineteen subjects with intractable partial seizures, at least three per month, were enrolled in a randomized clinical trial of omega-3 fatty acids in epilepsy. At study entry, subjects underwent a 1-hour ECG recording for the determination of HRV. To estimate the risk of SUDEP, we assembled a seven-item inventory (the SUDEP-7 Inventory) from risk factors prospectively validated by T.S. Walczak, I.E. Leppik, M. D'Amelio M, et al. (Neurology 2001;56:519-25). The SUDEP-7 score was then correlated with measures of HRV using the Pearson correlation and other parametric and nonparametric methods. RESULTS:Subjects had highly drug-resistant seizures, with a mean seizure frequency of 22.8 seizures per month. Scores on the SUDEP-7 inventory ranged from 1 to 7 of a maximum possible score of 12. RMSSD, a measure of high-frequency HRV, was inversely correlated with the SUDEP-7 score, r=-0.64, P=0.004. Subjects with higher SUDEP-7 scores had reduced levels of HRV (RMSSD). Other time-dependent measures of HRV (SDNN, SDANN) were not significantly correlated with SUDEP risk scores. CONCLUSIONS: RMSSD, a measure of HRV, which reflects the integrity of vagus nerve-mediated autonomic control of the heart, is highly associated with the total score on a new seven-item SUDEP risk inventory. Lower RMSSD values were associated with higher risk scores on the new SUDEP risk inventory. This provides new evidence that HRV (specifically RMSSD) is a marker of SUDEP risk.
RCT Entities:
OBJECTIVE: The goal of this study was to determine if specific measures of heart rate variability (HRV) are associated with the total score on a new seven-item inventory for sudden unexplained death in epilepsy (SUDEP). METHODS: Nineteen subjects with intractable partial seizures, at least three per month, were enrolled in a randomized clinical trial of omega-3 fatty acids in epilepsy. At study entry, subjects underwent a 1-hour ECG recording for the determination of HRV. To estimate the risk of SUDEP, we assembled a seven-item inventory (the SUDEP-7 Inventory) from risk factors prospectively validated by T.S. Walczak, I.E. Leppik, M. D'Amelio M, et al. (Neurology 2001;56:519-25). The SUDEP-7 score was then correlated with measures of HRV using the Pearson correlation and other parametric and nonparametric methods. RESULTS: Subjects had highly drug-resistant seizures, with a mean seizure frequency of 22.8 seizures per month. Scores on the SUDEP-7 inventory ranged from 1 to 7 of a maximum possible score of 12. RMSSD, a measure of high-frequency HRV, was inversely correlated with the SUDEP-7 score, r=-0.64, P=0.004. Subjects with higher SUDEP-7 scores had reduced levels of HRV (RMSSD). Other time-dependent measures of HRV (SDNN, SDANN) were not significantly correlated with SUDEP risk scores. CONCLUSIONS: RMSSD, a measure of HRV, which reflects the integrity of vagus nerve-mediated autonomic control of the heart, is highly associated with the total score on a new seven-item SUDEP risk inventory. Lower RMSSD values were associated with higher risk scores on the new SUDEP risk inventory. This provides new evidence that HRV (specifically RMSSD) is a marker of SUDEP risk.
Authors: T S Walczak; I E Leppik; M D'Amelio; J Rarick; E So; P Ahman; K Ruggles; G D Cascino; J F Annegers; W A Hauser Journal: Neurology Date: 2001-02-27 Impact factor: 9.910
Authors: H Ansakorpi; J T Korpelainen; H V Huikuri; U Tolonen; V V Myllylä; J I T Isojärvi Journal: J Neurol Neurosurg Psychiatry Date: 2002-01 Impact factor: 10.154
Authors: Melissa A de la Garza; David Poldiak; Robert Shade; Felipe S Salinas; Alex M Papanastassiou; C Ákos Szabó Journal: Epilepsy Res Date: 2019-06-12 Impact factor: 3.045
Authors: YuJaung Kim; Eduardo Bravo; Caitlin K Thirnbeck; Lori A Smith-Mellecker; Se Hee Kim; Brian K Gehlbach; Linda C Laux; Xiuqiong Zhou; Douglas R Nordli; George B Richerson Journal: J Clin Invest Date: 2018-02-12 Impact factor: 14.808
Authors: Charles Ákos Szabó; Margarita Akopian; David A González; Melissa A de la Garza; Melanie A Carless Journal: Epilepsia Date: 2019-10-08 Impact factor: 5.864
Authors: Domingo E Uceda; Xiang-Yang Zhu; John R Woollard; Christopher M Ferguson; Ioannis Patras; Daniel F Carlson; Samuel J Asirvatham; Amir Lerman; Lilach O Lerman Journal: Circ Arrhythm Electrophysiol Date: 2020-03-19
Authors: Tammy Y Euliano; Kostas Michalopoulos; Savyasachi Singh; Anthony R Gregg; Mariem Del Rio; Terrie Vasilopoulos; Amber M Johnson; Allison Onkala; Shalom Darmanjian; Neil R Euliano; Monique Ho Journal: Anesth Analg Date: 2018-03 Impact factor: 5.108