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Neurology and Neurosurgery Article in Press, Corrected Proof - Note to users |
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doi:10.1016/j.clineuro.2007.07.024
Copyright © 2007 Elsevier B.V. All rights reserved.
Cardiac responses of vagus nerve stimulation: Intraoperative bradycardia and subsequent chronic stimulation
J.J. Ardescha,
,
, H.P.J.
Buschmanb,
P.H. van der Burghc,
L.J.J.C. Wagener-Schimmela,
H.E. van der Aab,
d
and G. Hagemana
aDepartment of Neurology, Medisch Spectum
Twente, Enschede, The Netherlands
bTwente Institute for Neuromodulation,
Medisch Spectrum Twente, Enschede, The Netherlands
cDepartment of Cardiology, Medisch
Spectrum Twente, Enschede, The Netherlands
dDepartment of Neurosurgery, Medisch
Spectrum Twente, Enschede, The Netherlands
Received 6 May 2007; revised 29 July 2007; accepted 30 July
2007. Available online 6 September 2007.
Abstract
Objectives
Few adverse events on heart rate have been reported with vagus nerve stimulation (VNS) for refractory epilepsy. We describe three cases with intraoperative bradycardia during device testing.
Patients and methods
At our hospital 111 patients have received a VNS system. Intraoperative device testing is performed under ECG-monitoring. We reviewed the patients and their VNS-therapy follow-up outcome who experienced a change in heart rate, during device testing (Lead Test).
Results
Three patients with medically refractory epilepsy showed a bradycardia during intraoperative Lead Test. Postoperative the VNS-therapy started under ECG-monitoring. No change in cardiac rhythm occurred. Subsequent chronic stimulation is uneventful. All three have reduced seizure frequency. Two already have had their second implant, without the occurrence of bradycardia.
Conclusion
In case of intraoperative bradycardia VNS-therapy onset should be done under ECG-monitoring. Subsequent chronic stimulation is safe in respect to heart rate. Bradycardia during intraoperative device testing is no reason to abort the operation.
Keywords: Vagus nerve stimulation; Cardiac
responses; Epilepsy; Seizure; Chronic electrical stimulation
Corresponding
author at: Department of Neurology, Haaksbergerstraat 55, 7513 ER
Enschede, The Netherlands. Tel.: +31 53 4872850; fax: +31 53 4872882. | Clinical
Neurology and Neurosurgery Article in Press, Corrected Proof |
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