For epilepsy patients, seizures are more than disruptive. They can be life-threatening. In some cases, they lead to sudden unexpected death in epilepsy (SUDEP) or serious heart complications. Research has shown a strong connection between seizures and heart function, but capturing real-time cardiac data during seizures has been a long-standing challenge.

Traditional hospital monitors, which rely on wired electrodes attached to the chest, capture cardiac activity, but there’s potential to achieve even greater accuracy during critical moments. Leads can disconnect during convulsive seizures, producing gaps or inaccurate readings at critical moments. Without a clear picture of what happens to the heart during a seizure, doctors struggle to assess risk or intervene effectively.

A hospital-based study at Ochsner Health in New Orleans, La., is testing whether wearable technology can provide more accurate and continuous heart monitoring. The wireless and cloud-connected devices offer uninterrupted data without restricting movement by tracking cardiac activity before, during, and after seizures. Researchers hope the findings will improve risk assessment, guide treatment decisions, and even help predict seizures before they happen.

The Link Between Epilepsy and Cardiac Risk

Seizures can put significant stress on the heart. During a seizure, the body experiences a surge of sympathetic nervous system activity, causing sharp spikes in heart rate. In some cases, this response can trigger arrhythmias—irregular heart rhythms—that may disrupt blood flow and increase the risk of sudden cardiac complications.

After a seizure, the body may experience the opposite effect. Brain activity slows down, which can suppress critical functions like breathing and heart rate regulation. Researchers have long studied the connection between seizures and SUDEP, but the exact mechanisms remain unclear. The research suggests that seizures disrupt the brain’s ability to regulate the heart, either triggering dangerous arrhythmias or slowing breathing enough to cause oxygen deprivation.

The study uses Vivalink’s wearable ECG devices in the hospital’s epilepsy monitoring unit, where patients are already undergoing EEG and standard cardiac telemetry. It focuses on patients at high risk for generalized tonic-clonic seizures, which affect the entire brain and cause full-body convulsions. Patients in the study wear the device throughout their hospital stay, which typically lasts three to twelve days.

What Early Findings Reveal

While the study is still ongoing, preliminary data is helping researchers explore how seizures may affect the heart. Researchers have observed that some patients experience disruptions in the coordination between the upper and lower chambers of the heart during seizures. When this happens, the heart may become temporarily less efficient at pumping blood, which could reduce oxygen flow to the brain and other organs.

Seizures place extreme strain on the nervous system, and these cardiac irregularities may contribute to the heightened risk of sudden cardiac death in epilepsy patients. Understanding the timing and severity of these irregularities could be key to identifying patients who may be at higher risk for complications.

Researchers are also investigating potential changes in the heart’s electrical activity, particularly in the timing between beats. Some early data suggests, in certain cases, the intervals between heartbeats may become either too long or too short, which can interfere with the heart’s ability to maintain a stable rhythm. Since the autonomic nervous system typically regulates these fluctuations, researchers suspect that seizures may disrupt this process, leaving the heart vulnerable even after the seizure ends.

How Wearables Could Change Epilepsy Care

The study’s findings could have major implications for epilepsy treatment, particularly for patients at risk of cardiac complications. Identifying specific heart patterns linked to higher seizure risk could allow doctors to intervene sooner—whether by referring patients for cardiology evaluations, adjusting medications to reduce heart strain, or using neuromodulation therapies to help stabilize autonomic function.

Beyond treatment improvements, this research could also change how seizures are detected and managed in real time. If researchers identify consistent cardiac patterns that occur before a seizure, wearable devices could eventually track and recognize these signals, potentially helping to predict when a seizure is about to happen. Real-time heart monitoring could then trigger alerts for patients and caregivers, providing critical seconds or minutes to prepare—whether that means getting to a safe place, taking fast-acting medication, or notifying a provider.

Since some seizure medications can put extra strain on the heart, understanding epilepsy’s cardiac risks is even more important. With better data on how seizures affect heart function, neurologists can refine medication strategies to balance seizure control with heart health. For patients who experience post-seizure heart suppression, this research could also help doctors recommend extra safety measures, such as having a caregiver nearby at night or using respiratory monitors that detect distress.

Real-World Benefits of Continuous Monitoring

For many epilepsy patients, the unpredictability of seizures creates constant uncertainty about when the next episode will happen and the long-term risks to their health. Looking ahead, wearable technology could offer epilepsy patients even greater security beyond the hospital. Whether through real-time seizure alerts, improved treatment adjustments based on personalized cardiac data, or even early warning detection before a seizure begins, this technology has the potential to provide peace of mind and a more proactive approach to epilepsy care.

Dr. Fawad A. Khan is a neurologist at Ochsner Medical Center in New Orleans. He specializes in epilepsy and seizure disorders, headache care, and dizziness. He completed his residency in adult neurology at the University of North Carolina Hospitals in Chapel Hill, North Carolina. Dr. Khan completed a fellowship in clinical neurophysiology and epilepsy at the University of Michigan Hospitals in Ann Arbor, Michigan. He is the Section Head of The McCasland Family Comprehensive Headache Center and The International Center for Epilepsy at Ochsner. Dr. Khan is a clinician-researcher and is passionate about exploring innovative solutions to improve clinical care.