Vagus nerve stimulation with tachycardia detection provides additional seizure reduction compared to traditional vagus nerve stimulation
Vagus nerve stimulation with tachycardia detection provides additional seizure reduction compared to traditional vagus nerve stimulation
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DOI：
10.1016/j.yebeh.2020.107280
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发表时间：
2020-10-01
影响因子：
2.6
通讯作者：
Madhavan, Deepak
中科院分区：
文献类型：
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作者：
Datta, Proleta;Galla, Krishna Mourya;Madhavan, Deepak
目的：本研究探讨了从传统的迷走神经刺激（VNS）切换到反应性VNS（rVNS），其中有一个额外的发作性心动过速检测和刺激（AutoStim）model.Methods的临床和成本效益：回顾性图表审查被用来收集数据的患者进行发电机更换的难治性癫痫。排除了具有混杂因素（如药物变化）的患者。迷走神经刺激参数，癫痫发作频率，和医疗费用收集1年的时间内更换发电机与rVNS device.Results：记录癫痫发作频率可用于25例患者。植入rVNS后，28%的患者癫痫发作减少≥ 50%。平均每月癫痫发作次数显著减少（p = 0.039）。在尚未摆脱致残性癫痫发作的患者中（n - 17），41.2%的癫痫发作额外减少了>= 50%。在1年的随访期间，rVNS植入后的医疗费用与1年前相比没有差异。结论：阵发性心动过速检测和刺激在传统VNS治疗的致残性癫痫发作患者中提供了显着的临床获益。在器械更换后的第一年内，医疗费用没有额外增加。(C)2020爱思唯尔公司All rights reserved.
Purpose: This study investigates the dinical and cost effectiveness of switching from traditional vagus nerve stimulation (VNS) to responsive VNS (rVNS), which has an additional ictal tachycardia detection and stimulation (AutoStim) mode.Methods: Retrospective chart review was used to collect data from patients with medically refractory epilepsy who underwent generator replacements. Patients with confounding factors such as medication changes were excluded. Vagus nerve stimulation parameters, seizure frequency, and healthcare costs were collected for the 1-year period following generator replacement with the rVNS device.Results: Documented seizure frequency was available for twenty-five patients. After implant with rVNS, 28% of patients had an additional >= 50% seizure reduction. There was a significant decrease in the average monthly seizure count (p = 0.039). In patients who were not already free of disabling seizures (n - 17), 41.2% had >= 50% additional seizure reduction. There was no difference in healthcare costs during the 1-year follow-up after the rVNS implant compared with one year prior.Conclusions: Ictal tachycardia detection and stimulation provided a significant clinical benefit in patients who were not free of disabling seizures with treatment from traditional VNS. There was no additional increase in healthcare costs during the first year after device replacement. (C) 2020 Elsevier Inc. All rights reserved.