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Detection of epileptic seizures with a modified heart rate variability algorithm based on Lorenz plot

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Detection of epileptic seizures with a modified heart rate variability algorithm based on Lorenz plot. / Jeppesen, Jesper; Beniczky, Sándor; Johansen, Peter; Sidenius, Per; Fuglsang-Frederiksen, Anders.

In: Seizure - European Journal of Epilepsy, Vol. 24, 01.2015, p. 1-7.

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@article{8f89cbf34f8742d79a66bd553256b150,
title = "Detection of epileptic seizures with a modified heart rate variability algorithm based on Lorenz plot",
abstract = "Purpose: In order to assess whether focal epileptic seizures can be detected and distinguished from exercise we evaluated four different heart rate variability (HRV) methods with short term moving window analysis of 30,50 or 100 R-R intervals or seconds per analyzed window.Methods: The four methods consisted of: (1) reciprocal high frequency power based on Fast Fourier Transformation, (2) Cardiac Sympathetic Index (CSI), (3) Modified CSI both based on Lorenz plot, and (4) heart rate differential method. Seventeen patients (12 males, 5 females; age 20-55) had 47 seizures (including three secondary generalized tonic-clonic (sGTC)), which were analyzed during their long term video-EEG monitoring of 1-5 days duration. Positive seizure detection was regarded, when the HRV-value during seizures (1 min before to 3 min after seizure-onset) exceeded 105% of the highest value during exercise and non-seizure sample-periods of the same patient.Results: Modified CSI100 was the most accurate method: it detected all seizures for 13 of the 17 patients within 6 s before till 50 s after seizure onset time, even though exercise maximum HR of each patient exceeded that of the seizures. The three sGTC seizures were all detected more than half a minute before the tonic-clonic phase.Conclusion: The results indicate a detectable, sudden and inordinate shift toward sympathetic overdrive in the sympathovagal balance of the autonomic nervous system around seizure-onset time, for most patients. The Modified CSI is a promising parameter for a portable ECG-based epilepsy alarm, detecting both focal and sGTC seizures. (C) 2014 Published by Elsevier Ltd on behalf of British Epilepsy Association.",
keywords = "Autonomic nervous system, Epilepsy, Heart rate variability (HRV), Lorenz plot, Seizure alarm, Seizure detection, SUDDEN UNEXPECTED DEATH, DETECTION SYSTEMS, PARAMETERS, SUDEP",
author = "Jesper Jeppesen and S{\'a}ndor Beniczky and Peter Johansen and Per Sidenius and Anders Fuglsang-Frederiksen",
year = "2015",
month = jan,
doi = "10.1016/j.seizure.2014.11.004",
language = "English",
volume = "24",
pages = "1--7",
journal = "Seizure - European Journal of Epilepsy",
issn = "1059-1311",
publisher = "Elsevier Ltd",

}

RIS

TY - JOUR

T1 - Detection of epileptic seizures with a modified heart rate variability algorithm based on Lorenz plot

AU - Jeppesen, Jesper

AU - Beniczky, Sándor

AU - Johansen, Peter

AU - Sidenius, Per

AU - Fuglsang-Frederiksen, Anders

PY - 2015/1

Y1 - 2015/1

N2 - Purpose: In order to assess whether focal epileptic seizures can be detected and distinguished from exercise we evaluated four different heart rate variability (HRV) methods with short term moving window analysis of 30,50 or 100 R-R intervals or seconds per analyzed window.Methods: The four methods consisted of: (1) reciprocal high frequency power based on Fast Fourier Transformation, (2) Cardiac Sympathetic Index (CSI), (3) Modified CSI both based on Lorenz plot, and (4) heart rate differential method. Seventeen patients (12 males, 5 females; age 20-55) had 47 seizures (including three secondary generalized tonic-clonic (sGTC)), which were analyzed during their long term video-EEG monitoring of 1-5 days duration. Positive seizure detection was regarded, when the HRV-value during seizures (1 min before to 3 min after seizure-onset) exceeded 105% of the highest value during exercise and non-seizure sample-periods of the same patient.Results: Modified CSI100 was the most accurate method: it detected all seizures for 13 of the 17 patients within 6 s before till 50 s after seizure onset time, even though exercise maximum HR of each patient exceeded that of the seizures. The three sGTC seizures were all detected more than half a minute before the tonic-clonic phase.Conclusion: The results indicate a detectable, sudden and inordinate shift toward sympathetic overdrive in the sympathovagal balance of the autonomic nervous system around seizure-onset time, for most patients. The Modified CSI is a promising parameter for a portable ECG-based epilepsy alarm, detecting both focal and sGTC seizures. (C) 2014 Published by Elsevier Ltd on behalf of British Epilepsy Association.

AB - Purpose: In order to assess whether focal epileptic seizures can be detected and distinguished from exercise we evaluated four different heart rate variability (HRV) methods with short term moving window analysis of 30,50 or 100 R-R intervals or seconds per analyzed window.Methods: The four methods consisted of: (1) reciprocal high frequency power based on Fast Fourier Transformation, (2) Cardiac Sympathetic Index (CSI), (3) Modified CSI both based on Lorenz plot, and (4) heart rate differential method. Seventeen patients (12 males, 5 females; age 20-55) had 47 seizures (including three secondary generalized tonic-clonic (sGTC)), which were analyzed during their long term video-EEG monitoring of 1-5 days duration. Positive seizure detection was regarded, when the HRV-value during seizures (1 min before to 3 min after seizure-onset) exceeded 105% of the highest value during exercise and non-seizure sample-periods of the same patient.Results: Modified CSI100 was the most accurate method: it detected all seizures for 13 of the 17 patients within 6 s before till 50 s after seizure onset time, even though exercise maximum HR of each patient exceeded that of the seizures. The three sGTC seizures were all detected more than half a minute before the tonic-clonic phase.Conclusion: The results indicate a detectable, sudden and inordinate shift toward sympathetic overdrive in the sympathovagal balance of the autonomic nervous system around seizure-onset time, for most patients. The Modified CSI is a promising parameter for a portable ECG-based epilepsy alarm, detecting both focal and sGTC seizures. (C) 2014 Published by Elsevier Ltd on behalf of British Epilepsy Association.

KW - Autonomic nervous system

KW - Epilepsy

KW - Heart rate variability (HRV)

KW - Lorenz plot

KW - Seizure alarm

KW - Seizure detection

KW - SUDDEN UNEXPECTED DEATH

KW - DETECTION SYSTEMS

KW - PARAMETERS

KW - SUDEP

U2 - 10.1016/j.seizure.2014.11.004

DO - 10.1016/j.seizure.2014.11.004

M3 - Journal article

C2 - 25564311

VL - 24

SP - 1

EP - 7

JO - Seizure - European Journal of Epilepsy

JF - Seizure - European Journal of Epilepsy

SN - 1059-1311

ER -