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Clin Neurol Neurosurg. 2007 Dec;109(10):849-52. Epub 2007 Sep 6.

Cardiac responses of vagus nerve stimulation: intraoperative bradycardia and subsequent chronic stimulation.

Author information

1
Department of Neurology, Medisch Spectum Twente, Enschede, The Netherlands. j.ardesch@ziekenhuis-mst.nl

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.

PMID:
17825483
DOI:
10.1016/j.clineuro.2007.07.024
[Indexed for MEDLINE]

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