Acute Slow Wave Responses to High-Frequency Gastric Electrical Stimulation in Patients With Gastroparesis Defined by High-Resolution Mapping

Show simple item record Angeli, Timothy en Du, Peng en Midgley, D en Paskaranandavadivel, Niranchan en Sathar, Shameer en Lahr, C en Abell, TL en Cheng, Leo en O'Grady, Gregory en 2017-02-09T22:26:22Z en 2016-12 en
dc.identifier.citation Neuromodulation 19(8):864-871 Dec 2016 en
dc.identifier.issn 1094-7159 en
dc.identifier.uri en
dc.description.abstract High-frequency gastric electrical stimulation (GES) has emerged as a therapy for gastroparesis, but the mechanism(s) of action remain unclear. There is a need to refine stimulation protocols for clinical benefit, but a lack of accurate techniques for assessing mechanisms in clinical trials, such as slow wave modulation, has hindered progress. We thereby aimed to assess acute slow wave responses to GES in gastroparesis patients using high-resolution (HR) (multi-electrode) mapping, across a range of stimulation doses achievable by the Enterra stimulation device (Medtronic Inc., MN, USA).Patients with medically refractory gastroparesis (n = 8) undergoing device implantation underwent intraoperative HR mapping (256 electrodes). Baseline recordings were followed by four protocols of increasing stimulation intensity, with washout periods. Slow wave patterns, frequency, velocity, amplitude, and dysrhythmia rates were quantified by investigators blinded to stimulation settings.There was no difference in slow wave pattern, frequency, velocity, or amplitude between baseline, washout, and stimulation periods (all p > 0.5). Dysrhythmias included ectopic pacemakers, conduction blocks, retrograde propagation, and colliding wavefronts, and dysrhythmia rates were unchanged with stimulation off vs. on (31% vs. 36% duration dysrhythmic; p > 0.5). Symptom scores and gastric emptying were improved at 5.8 month follow-up (p < 0.05).High-frequency GES protocols achievable from a current commercial device did not acutely modulate slow wave activity or dysrhythmias. This study advances clinical methods for identifying and assessing therapeutic GES parameters, and can be applied in future studies on higher-energy protocols and devices. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.publisher Blackwell Publishing Inc. en
dc.relation.ispartofseries Neuromodulation en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.title Acute Slow Wave Responses to High-Frequency Gastric Electrical Stimulation in Patients With Gastroparesis Defined by High-Resolution Mapping en
dc.type Journal Article en
dc.identifier.doi 10.1111/ner.12454 en
pubs.issue 8 en
pubs.begin-page 864 en
pubs.volume 19 en
dc.rights.holder Copyright: Wiley en
dc.identifier.pmid 27284964 en
pubs.end-page 871 en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 530978 en Bioengineering Institute en ABI Associates en Engineering en Engineering Science en Medical and Health Sciences en School of Medicine en Surgery Department en
dc.identifier.eissn 1525-1403 en
pubs.record-created-at-source-date 2016-12-02 en 2016-06-10 en
pubs.dimensions-id 27284964 en

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