title: Analysis of 24-hour heart rate variations in patients with epilepsy receiving antiepileptic drugs.
abstract: OBJECTIVE
  The goal of the study described here was to evaluate interictal heart rate variability (HRV) in young patients with epilepsy, a patient population in whom sudden unexpected death in epilepsy (SUDEP) is known to be more common.
  
  
  METHODS
  Twenty-four-hour ambulatory ECG Holter recordings of 37 patients (15-40 years old) and 32 healthy controls were compared.
  
  
  RESULTS
  All of the time domain indices (SDNN, SDANN, RMSSD, and HRV triangular index) were significantly suppressed (P<0.001), and there was a marked reduction in parasympathetic tone (reduced HF(nu,)P<0.001) and an increase in sympathetic tone (increased LF(nu) and LF/HF ratio, P<0.001) in the patient group. Stepwise linear regression analysis revealed that polytherapy and epilepsy duration >10 years were independent variables associated with a reduction in SDNN.
  
  
  CONCLUSIONS
  Our data suggest that the major determinants of suppressed SDNN are polytherapy and epilepsy duration >10 years. Analysis of spectral measures of frequency domain indices suggests that an increased sympathetic tone in association with a decreased parasympathetic tone may constitute the mechanism underlying SUDEP in young people with epilepsy.
authors.affiliation: Department of Neurology, Selcuk University Meram School of Medicine, Konya, Turkey.
authors.forename: Gulce Unal
authors.initials: GU
authors.lastname: Yildiz
authors.forename: Ebru Apaydin
authors.initials: EA
authors.lastname: Dogan
authors.forename: Umuttan
authors.initials: U
authors.lastname: Dogan
authors.forename: Osman Serhat
authors.initials: OS
authors.lastname: Tokgoz
authors.forename: Kurtulus
authors.initials: K
authors.lastname: Ozdemir
authors.forename: Bulent Oguz
authors.initials: BO
authors.lastname: Genc
authors.forename: Nurhan
authors.initials: N
authors.lastname: Ilhan
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D016757:Death, Sudden, Cardiac; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory / Q000379:methods; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult
chemical_list: D000927:Anticonvulsants