Role Heart Rate Variability Plays in SUDEP Research, Prevention: Orrin Devinsky, MD

WATCH TIME: 3 minutes

"You design a trial where one group gets the education, and the other group gets the seizure detection watch with someone nearby. If you could prove that [the detection of HRV] worked, then it not only will become something insurances cover much more readily, but it can become the standard of care and allow a bit of pressure on not just epilepsy specialists, but neurologists in general, to prescribe it and use it. But we’re not there yet.”

Recently published research found heart rate variability (HRV), a simple diagnostic measure of cardiac autonomic function, to potentially help identify patients with epilepsy at risk for sudden unexpected death (SUDEP). Reduced low-frequency power, a validated biomarker for sudden death in patients with heart disease, was associated with SUDEP risk when measured during wakefulness in individuals with epilepsy.

Senior author Orrin Devinsky, MD, noted that these findings are crucial for the community as there has been little to no direction in who may be more at risk for SUDEP. The study featured 31 SUDEP cases and 56 controls, which Devinsky said need further validation in larger settings. Even then, the finding opens a massive wormhole of opportunities for clinicians to explore more about the associations between HRV and SUDEP, and ways the biomarker can be used to prevent it from occurring.

Devinsky, director of the Comprehensive Epilepsy Center at NYU Langone, provided insight on how this new biomarker impacts the SUDEP research space, including the inclusion and exclusion criteria for clinical trials. He also touched upon whether literature has indicated different HRVs for epilepsy subtypes, as well as which direction he plans to take his research next.