Late-onset cardiac arrhythmia associated with vagus nerve stimulation

Borusiak, Peter; Cagnoli, Sabine; Heldmann, Michael; Jenke, Andreas

doi:10.1007/s00415-009-5162-y

Cited by 19 publications

(11 citation statements)

References 15 publications

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“…As pointed out in a preceding case, VNS is not expected to cause efferent stimulation of the vagus nerve cardiac fibers, hence bradycardia and asystole are unusual adverse effect [1]. Previous cases had raised possible contribution of newly added levetiracetam for status epilepticus [2], and worsening seizure and changes in AED [3]. In our case, VNS parameters, seizure frequency, and AED regimen were unchanged for relatively long period of time.…”

Section: Discussionmentioning

confidence: 51%

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Vagus nerve stimulation and late-onset bradycardia and asystole: Case report

Pascual

2015

Seizure

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Section: Discussionmentioning

confidence: 51%

“…Their ages were 13, 17, 47, and 55. Cardiac symptoms were noted after 2.33-9 years postimplantation [1][2][3][4]. Three cases had symptoms correlated with stimulation, monitored by electrocardiogram [1,2,4].…”

Section: Introductionmentioning

confidence: 98%

Vagus nerve stimulation and late-onset bradycardia and asystole: Case report

Pascual

2015

Seizure

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“…All clinical data are shown in Table 1 . The 22 patients [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] in the arrhythmia group comprised of 8 females and 16 males (mean age, 39 years; range, 8–59 years), while the 29 patients in the control group comprised of 11 females and 18 males (mean age, 31 years; range, 9–52 years). The arrhythmia group was significantly older than the control group (p = 0.038).…”

Section: Resultsmentioning

confidence: 99%

New onset syncopal events following vagus nerve stimulator implantation might be key to preventing vagus nerve stimulation-induced symptomatic bradycardia — A case report and review

Kato

Fujimoto

Okanishi

et al. 2018

Epilepsy & Behavior Case Reports

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PurposeTo identify risk factors for VNS-associated arrhythmia.MethodsA literature review identified 14 papers with 21 patients. We compared patients with VNS associated arrhythmia (arrhythmia group, n = 22) and patients without VNS associated arrhythmia (control group of our VNS implanted patients, n = 29).ResultsNew onset syncopal events following VNS placement were seen in the arrhythmia group (p < 0.001).ConclusionEven though arrhythmia could be symptomatic, most cases associated with syncope were treated as new-onset epileptic seizures with adjustment of anti-seizure drugs. To detect cardiac asystole during VNS treatment, clinicians should be alert to the possibility of new onset syncopal events that differ from habitual seizures.

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“…The attacks occurred during stimulation and stopped when the VNS device was turned off . Another report described intermittent self‐terminating complete heart block occurring every 15–25 min and lasting 20–40 s that occurred 6.5 years after the implantation of a VNS device for the treatment of epilepsy . A third case reported periodic asystole 9 years after implantation .…”

Section: Effectiveness Of Implantable Vnsmentioning

confidence: 99%

Surgically implanted and non‐invasive vagus nerve stimulation: a review of efficacy, safety and tolerability

Ben‐Menachem

Révész

Simon³

et al. 2015

Euro J of Neurology

260

205

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Vagus nerve stimulation (VNS) is effective in refractory epilepsy and depression and is being investigated in heart failure, headache, gastric motility disorders and asthma. The first VNS device required surgical implantation of electrodes and a stimulator. Adverse events (AEs) are generally associated with implantation or continuous on−off stimulation. Infection is the most serious implantation‐associated AE. Bradycardia and asystole have also been described during implantation, as has vocal cord paresis, which can last up to 6 months and depends on surgical skill and experience. The most frequent stimulation‐associated AEs include voice alteration, paresthesia, cough, headache, dyspnea, pharyngitis and pain, which may require a decrease in stimulation strength or intermittent or permanent device deactivation. Newer non‐invasive VNS delivery systems do not require surgery and permit patient‐administered stimulation on demand. These non‐invasive VNS systems improve the safety and tolerability of VNS, making it more accessible and facilitating further investigations across a wider range of uses.

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Late-onset cardiac arrhythmia associated with vagus nerve stimulation

Cited by 19 publications

References 15 publications

Vagus nerve stimulation and late-onset bradycardia and asystole: Case report

Vagus nerve stimulation and late-onset bradycardia and asystole: Case report

New onset syncopal events following vagus nerve stimulator implantation might be key to preventing vagus nerve stimulation-induced symptomatic bradycardia — A case report and review

Surgically implanted and non‐invasive vagus nerve stimulation: a review of efficacy, safety and tolerability

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