Abstracts

Rationale: Vagus Nerve Stimulation (VNS) is an established treatment for patients with pharmacoresistant epilepsy, for whom surgery is not recommended. Methods: A 22 y/o female hispanic patient with pharmacoresistant epilepsy was evaluated for surgery. Surgical resection was ruled out because the epileptogenic zone could not be precisely localized in this MRI negative-patient and a VNS implantation was decided. Results: The surgical standard procedure for VNS implantation was carried out. During the intraoperative system diagnostic test (1.0 mA, 20Hz, 500 µs), the patient developed asystole for 8 seconds. The heart rate recovered spontaneously without any medication or resuscitation maneuver. A second trial was performed in which the patient developed asystole again. The procedure was stopped and the VNS was left in place, deactivated. The patient had no history of any other disease. A complete cardiac evaluation was performed and underlying abnormalities were discharged. After activating the device in the coronary care unit, no abnormalities in the heart rate were presented. The device was left activated with good tolerance to 0.25 mA and, in the last month, the intensity was increased to 0.5 mA. Conclusions: Asystole, although extremely rare, should be considered as a serious life-threatening complication of the VNS. However, the device was activated, under safety rules, with good tolerance and without any subsequent cardiac adverse events. Funding: No