Heart rate variability in patients with untreated epilepsy

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Persson H, Ericson M, and Tomson T (2007) Heart rate variability in patients with untreated epilepsy. Seizure 16:6 504–8.

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Abstract: BACKGROUND: Several studies have reported reduced heart rate variability (HRV) in patients with chronic epilepsy under treatment with antiepileptic drugs. This impairment in cardiac autonomic control might be of relevance in relation to the risk of sudden unexpected death in patients with chronic refractory epilepsy. Little information is, however, available on HRV in untreated patients with newly diagnosed epilepsy. METHODS: We used spectral analysis to assess HRV based on 24h ambulatory EKG recordings in 22 consecutive untreated patients with epilepsy (15 with localization-related, 4 with generalized idiopathic and 3 with undetermined epilepsy). The HRV in these patients was compared with 22 age and sex matched healthy controls. RESULTS: When analysing the full 24h recordings, there were no significant difference between the patients and the controls in any of the analyzed measures of HRV: standard deviation of RR-intervals (P=0.191), total power (P=0.170), very low frequency power (P=0.329), low frequency power (LF) (P=0.161), high frequency power (HF) (P=0.186) and the LF/HF ratio (P=0.472). The results were very similar for daytime and nighttime recordings. CONCLUSION: Our results suggest that there is no major effect of epilepsy as such on HRV in patients with untreated epilepsy. It should be emphasized that this study assessed newly diagnosed patients and that the results may not be applicable to patients with chronic epilepsy.

Keywords: SUDEP; Heart rate variability; Epilepsy; Untreated


  • HRV was assessed from ambulatory EKG in 22 newly diagnosed epilepsy patients not taking medications, then compared to matched healthy controls. No difference in EKG parameters was identified, suggesting that changes seen in Evrengül et al. may result from chronic epilepsy and/or from AED treatment. See also Persson et al.