People with epilepsy are at a higher risk for sudden unexpected death than the general population. Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in this population, accounting for 10-50% of deaths for those with epilepsy. The risk for SUDEP is particularly high for those with refractory epilepsy. Several lines of evidence support a cardiac mechanism for SUDEP.

This study plans to determine:

1. the frequency and types of cardiac arrhythmias that occur in this population and
2. whether these are increased above the general population in the same age group.

Additionally, these data will be correlated to specific clinical data, including seizure history, anticonvulsant medications, and any accompanying clinical symptoms.

By employing long-term electrocardiographic monitoring, this study plans to determine:

1. the frequency and types of cardiac arrhythmias that occur in patients with uncontrolled seizures and
2. whether these are increased above the general population in the same age group.

The specific aims:

1. Identify the types, frequency, and duration of cardiac arrhythmias that occur in patients with refractory epilepsy and compare these data to available normative data.

2. Correlate abnormal heart rates and rhythms to specific clinical data:

   1. seizure type,
   2. seizure frequency,
   3. probable location of seizure onset in the brain, when such data are available,
   4. duration of seizures, and
   5. type(s) and number of anticonvulsant medications being used.

3. Correlate cardiac arrhythmias to clinical symptoms

Inclusion Criteria:

• Refractory epilepsy

Exclusion Criteria:

• Other pre-existing heart conditions

Individuals with refractory focal or generalized epilepsy.