John Libbey Eurotext

Early experiences with tachycardia-triggered vagus nerve stimulation using the AspireSR stimulator Volume 18, issue 2, June 2016

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Authors
1 Department of Neurology, Centre for Refractory Epilepsy, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
2 Epilepsy Centre, Medical Center – University of Freiburg, Faculty of Medecine, Freiburg, Germany
3 Department of Neurosurgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
4 Department of Stereotactic and Functional Neurosurgery, Medical Center – University of Freiburg, Faculty of Medecine, Freiburg, Germany
* Correspondence: Riëm El Tahry Department of Neurology, Center for Refractory Epilepsy, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Av. Hippocrate 10, 1200 Brussels, Belgium

Many epilepsy patients treated with vagus nerve stimulation additionally use an “on-demand” function, triggering an extra stimulation to terminate a seizure or diminish its severity. Nevertheless, a substantial number of patients are not able to actively trigger stimulations by use of a magnet, due to the absence of an aura or inability for voluntary actions in the early phase of a seizure. To address this need, a novel implantable pulse generator, the AspireSR VNS system, was developed to provide automated ictal stimulation triggered by a seizure-detecting algorithm. We report our experience with three patients in assessing the functionality of ictal stimulation, illustrating the detection system in practice. Detection of ictal tachycardia and variable additional detections of physiological tachycardia depended on the individual seizure-detecting algorithm settings.