Ictal tachycardia: the head-heart connection

Area of Science:

• Neurology
• Cardiology
• Biomedical Engineering

Background:

• Epileptic seizures impact autonomic nervous system functions.
• Cardiac signal changes, particularly heart rate, are potential extra-cerebral seizure biomarkers.
• Heart rate monitoring offers a feasible method for seizure detection compared to other biomarkers.

Purpose of the Study:

• To review the prevalence and characteristics of heart rate changes during epileptic seizures.
• To understand the timing and magnitude of ictal tachycardia for developing cardiac-based seizure detection algorithms.

Main Methods:

• Systematic review of 34 articles reporting ictal tachycardia in epilepsy patients.
• Analysis of concurrent electroencephalogram (EEG) and electrocardiogram (ECG) data.

Main Results:

• Significant heart rate increases (ictal tachycardia) occur in 82% of epilepsy patients during seizures.
• Prevalence of significant heart rate changes was 64% for generalized and 71% for partial onset seizures.
• Temporal lobe epilepsy seizures were most frequently associated with significant heart rate increases; considerable intra-individual variability exists.

Conclusions:

• Cardiac monitoring, specifically heart rate, is a viable tool for seizure detection.
• The high prevalence and variability of ictal tachycardia underscore the need for adaptable seizure detection algorithms with adjustable thresholds.