Late‐onset periodic asystolia during vagus nerve stimulation

• Published in: Epilepsia (Copenhagen) Vol. 50; no. 4; pp. 928 - 932
• Main Authors: Iriarte, Jorge, Urrestarazu, Elena, Alegre, Manuel, Macías, Alfonso, Gómez, Asier, Amaro, Paola, Artieda, Julio, Viteri, Cesar
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2009; Wiley-Blackwell
• Subjects: Asystole; Biological and medical sciences; Diseases of the nervous system; Electrocardiography - methods; Electroencephalography; Epilepsy; Epilepsy - therapy; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Heart Arrest - etiology; Humans; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Vagal stimulation; Vagus Nerve Stimulation - adverse effects; Nervous system diseases; Arrhythmia; Heart disease; Epilepsy; Central nervous system disease; Cardiovascular disease; Vagal stimulation; Vagus nerve; Excitability disorder; Asystole; Cerebral disorder
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.1528-1167.2008.01918.x

Summary Cardiac changes may occasionally occur during vagus nerve stimulation (VNS) used in epileptic patients. As they can be potentially life‐threatening, it is important to detect them, and this is why an intraoperative test is performed during the implantation. Few cases of asystole during this test have been described. Only one patient with late‐onset bradyarrythmia caused by VNS has been reported. This patient had been implanted 2 years and 4 months before the episode. We present another case of late asystole in a patient whose VNS had been implanted 9 years before the arrhythmia onset. In our patient, each run of stimulation produced bradyarrhythmias and very often severe asystolia due to atrium‐ventricular block.