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Vagus nerve stimulation (VNS) is a well-known therapeutic option for patients with refractory epilepsy who do not respond to adequate anti-epileptic drugs. Heart rate variability (HRV) is mediated by sympathetic and parasympathetic efferent activities which always interact towards the heart. Our goal was to describe the link between autonomic nervous system (ANS) and HRV. In 18 epileptic children, ECG data were obtained before and after implantation of the VNS. HRV was measured by linear and nonlinear parameters during 50 minute epochs during phase 2 of sleep and deep sleep. Results of the patients were compared with those of an age and sex matched control group. We were able to confirm that vagus nerve stimulation do not influence heart rate in children with refractory epilepsy. After the VNS implantation, there is a shift in sympathovagal balance towards sympathetic predominance in phase 2 of sleep (p=0.177) and also during deep sleep (p=0.035). This study suggests that left vagus nerve stimulation has little effect on heart rate variability as measured by nonlinear parameters.

HEART RATE VARIABILITY ANALYSIS OF CHILDREN WITH REFRACTORY EPILEPSY BEFORE AND AFTER THE VAGUS NERVE STIMULATION