Late onset bradyarrhythmia during vagus nerve stimulation

Area of Science:

• Neurology
• Cardiology
• Medical Devices

Background:

• Vagus nerve stimulation (VNS) is a common treatment for refractory epilepsy, generally considered safe with minimal side effects.
• Cardiac arrhythmias have been anecdotally reported during VNS lead testing but not during established treatment.

Observation:

• A patient developed syncope-like episodes two years and four months post-VNS implantation.
• These episodes were precisely correlated with VNS stimulation periods.

Findings:

• The patient experienced vagally induced bradyarrhythmia, a previously unreported severe side effect of long-term VNS treatment.
• No underlying cause for the bradyarrhythmia was identified, suggesting a direct link to VNS.

Implications:

• This case highlights a potentially severe and life-threatening complication of VNS therapy.
• Clinicians should be aware of this rare possibility, even after prolonged VNS treatment, to ensure patient safety.