Detection of major epileptic seizures with heart rate changes: feasibility test of a state-of-the-art wearable sensor

Purpose: To develop and validate a wearable ultra-low power prototype device for ECG-based epileptic seizure detection. Method: This observational study is a nonrandomized, open, single-site, clinical test in 10 subjects (30–50 seizures) previously diagnosed with frequent (>1/week) major epileptic seizures (tonic–clonic, generalized tonic or clonic) with heart rate changes. A wearable device running a previously developed algorithm [van Elmpt WJ et al. Seizure 2006; 15(6):366–75] for heart rate based seizure detection was tested at night during 1–4 weeks per patient. Objectives were the sensitivity, positive predictive value and technical feasibility. Results were verified by visual analysis of recorded video and comparison to previously analyzed EEGvideo data. Results: In the first 3 patients 100% of major seizures were detected; however at the cost of many false positives. Reanalysis of the data showed that optimizing parameter settings of the detection algorithm considerably improved positive predictive value. Exact results will be presented. Conclusion: Heart rate–based detection of major seizures by the proposed wearable sensor system is feasible.