Evidence map›Paper›PMID 40439993›Full record

ReviewEpilepsia open2025

Late-onset asystole associated with vagal nerve stimulation.

Divya Nagabushana, Huan Huynh, Mark D McCauley, Anna Serafini

Abstract readCase ReportsReview
In one paragraph

Review in Epilepsia open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Divya NagabushanaEpilepsy Division, Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-0427-1452
Huan HuynhEpilepsy Division, Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, Illinois, USA.
Mark D McCauleyDepartment of Cardiology, University of Illinois Chicago, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0003-2743-2113
Anna SerafiniEpilepsy Division, Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, Illinois, USA.

Funding

Myosin Light Chain Dephosphorylation by PPP1R12C Promotes Atrial Hypocontractility and Atrial FibrillationR01HL151508 · NHLBI · UNIVERSITY OF ILLINOIS AT CHICAGO · PI MCCAULEY, MARK D · 2020 to 2024
$3.2M
NHLBI NIH HHS R01 HL151508
6 · The paper itself

Abstract

Vagal nerve stimulation (VNS) is a form of neuromodulation that is an established adjunct in the management of drug-resistant epilepsy. The common side effects of VNS are cough, dysphonia, or shortness of breath, which are often mild and do not require discontinuation of therapy. However, serious adverse effects such as bradyarrhythmia and asystole can occur rarely in patients who have had VNS implanted several years ago due to certain technical issues, patient-related risk factors, and unknown causes that necessitate the deactivation of VNS. We describe the late onset of bradyarrhythmia in a 32-year-old patient with drug-resistant epilepsy 2 years after the implantation of VNS and the subsequent management. We also review similar cases in the literature to understand their mechanism of asystole and the antecedent risk factors. In conclusion, when selecting a patient for VNS, all the possible risk factors for adverse cardiac events should be considered. Initial EKG Holter prior to implantation and periodic monitoring is recommended for patients on VNS. PLAIN LANGUAGE SUMMARY: Vagal nerve stimulation (VNS) is a treatment used alongside medication for people with epilepsy who do not respond to drugs. It usually causes mild side effects such as cough or voice changes. Rarely, it can lead to serious heart problems such as slow heartbeat or heart stoppage, even years after the device is implanted. This report describes such a case in a 32-year-old patient and reviews similar cases to understand the risks. The authors recommend checking heart health with tests like an electrocardiogram before starting VNS and doing regular follow-up checks to help prevent serious complications.

Indexed as

Drug Resistant EpilepsyHeart ArrestVagus Nerve StimulationAdultFemaleHumansMaleasystolebradyarrhythmiacardiaclate‐onsetsyncopevagal nerve stimulation

Identifiers

PMID40439993
PMCPMC12362184

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.