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Familoni, Babajide O.; Abell, Thomas L.; Voeller, Guy; Salem, A.A.; Gaber, A. Osama

doi:10.1023/a:1018852011857

Cited by 121 publications

(18 citation statements)

References 3 publications

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“…Previous studies conducted in single centers [11, 12]have shown that gastric electrical stimulation reduces the overall symptom scores in the short term. In these studies, as in the present one, the symptomatic improvement is not directly correlated with a concomitant improvement of gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

“…However, the results have been inconsistent, particularly when the effects of gastric stimulation were studied shortly after surgery [8]. More recently, in a single patient, Familoni et al [11]suggested that gastric electrical stimulation might favorably affect gastric emptying when applied over a longer period. McCallum et al [12]have recently reported improved gastric emptying after using gastric electrical stimulation at frequencies near the intrinsic slow-wave frequency for 1 month, with the majority of patients (6/9) showing improved gastric emptying, even after several months of stimulation.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, they were able to improve gastric emptying for up to a year using gastric electrical stimulation in a young woman with diabetic gastroparesis [11]. More recently, McCallum et al [12]reported a short-term improvement in gastric emptying in gastroparetic patients using high-energy, transcutaneous electrical stimulation of the stomach at stimulation frequencies that approximate the intrinsic slow-wave frequency of the stomach.…”

Section: Introductionmentioning

confidence: 99%

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Gastric Electrical Stimulation in Intractable Symptomatic Gastroparesis

et al. 2002

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Background: The treatment of gastroparesis remains unsatisfactory despite prokinetic and anti-emetic drugs. Gastric electrical stimulation has been proposed as a therapeutic option. We have assessed the effect of gastric electrical stimulation on symptoms, medical treatment, body weight and gastric emptying in patients with intractable symptomatic gastroparesis in a non-placebo-controlled study. Methods: In this multicenter study, 38 highly symptomatic patients with drug-refractory gastroparesis were enrolled. Patients first received temporary electrical stimulation using percutaneous electrodes. The 33 responders to temporary stimulation then underwent surgical implantation of a permanent stimulator. Severity of vomiting and nausea was assessed before and after stimulation. Patients were reassessed 3, 6, and 12 months after permanent implantation. Results: With stimulation, 35/38 patients (97%) experienced >80% reduction in vomiting and nausea. This effect persisted throughout the observation period (2.9–15.6 months, 341 patient-months). Gastric emptying did not initially change, but improved in most patients at 12 months. At 1 year, the average weight gain was 5.5% and 9/14 patients initially receiving enteral or parenteral nutrition were able to discontinue it. Conclusion: Electrical stimulation of the stomach has an immediate and potent anti-emetic effect. It offers a safe and effective alternative for patients with intractable symptomatic gastroparesis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gastric Electrical Stimulation in Intractable Symptomatic Gastroparesis

et al. 2002

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“…Gastric electrical stimulation (GES) has been used for over a decade. Familoni et al [6] used electrical stimulation of the gastric musculature at a higher frequency than the intrinsic slow-wave activity to induce peristalsis in the canine stomach and then were able to improve gastric emptying in a patient with diabetic gastroparesis using a similar technique [7]. GES received FDA Humanitarian Use Device approval in 2000 and differs from high-energy/low-frequency stimulation or gastric pacing which remains investigational [8].…”

Section: Introductionmentioning

confidence: 99%

Gastric Electrical Stimulation Is Safe and Effective: A Long-Term Study in Patients with Drug-Refractory Gastroparesis in Three Regional Centers

et al. 2007

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Background: Drug-refractory gastroparesis has previously been without acceptable alternative therapies. Although gastric electrical stimulation has been used for over a decade, no long-term multicenter data exist. Methods: We studied 214 consecutive drug-refractory patients with the symptoms of gastroparesis (146 idiopathic, 45 diabetic, 23 after surgery) who consented to participate in a variety of clinical research and clinical protocols at three centers from January 1992 through January 2005, resulting in 156 patients implanted with a gastric electrical stimulation device and the other 58 patients serving as controls. The patients were stratified into three groups: (1) consented but never permanently implanted; (2) implanted with permanent device, and (3) consented while awaiting a permanent device. The patients were followed over time for gastrointestinal symptoms, solid gastric emptying, health-related quality of life, survival, device retention, and complications. Demographics, descriptive statistics, and t tests were used for comparison between baseline and latest follow-up. Results: At latest follow-up, median 4 years for 5,568 patient months, most patients implanted (135 of 156) were alive with intact devices, significantly reduced gastrointestinal symptoms, and improved health-related quality of life, with evidence of improved gastric emptying, and 90% of the patients had a response in at least 1 of 3 main symptoms. Most patients explanted, usually for pocket infections, were later reimplanted successfully. There were no deaths directly related to the device. Conclusion: Based on this sample of patients, implanted with gastric electrical stimulation devices at three centers and followed for up toward a decade, gastric electrical stimulation for drug-refractory gastroparesis is both safe and effective.

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“…Researchers have advocated pacing signals at frequencies close to that of the native ECA, 4,5,17 three or four times that, 3,6,7,13 or frequencies two orders of magnitude higher. 19 GES at these various frequencies have been employed in dog and man with mixed results for ECA entrainment.…”

Section: Introductionmentioning

confidence: 99%

Driving Gastric Electrical Activity with Electrical Stimulation

et al. 2005

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Gastric electrical stimulation (GES) therapy is generating a lot of interest, but it is still investigational. Its efficacy in driving gastric electrical activity and improving motility, and the ideal frequency for bringing this about are still controversial. In this study, a rule-based computer model of tissue electrical response to stimulation was developed to examine the interaction between tissue electrical refractoriness and the onset of tissue activation. The results were compared to response to GES in 8 dogs implanted with electrodes and strain gauges and stimulated at frequencies ranging from 3 to 30 cycles/min. Simulated electrical control activity at an intrinsic frequency of 5/min was entrained from 2.0 cycles/min to 7.92 cycles/min. The regularity of the ECA elicited by stimulation depended on the number of pulses injected. Electrical stimulation in canine stomach entrained the native electrical control activity from a baseline average of 5.14 +/- 0.32 cycles/min up to 9.2 cycles/min. Contractile response to stimulation at 20-30 cycles/min were significantly higher (p < 0.05). Computer simulation of GES may be a useful tool to complement and reduce some of the costs associated with empirical studies of gastric electrical stimulation in establishing its possible use in treating drug refractory gastroparesis.

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Cited by 121 publications

References 3 publications

Gastric Electrical Stimulation in Intractable Symptomatic Gastroparesis

Gastric Electrical Stimulation in Intractable Symptomatic Gastroparesis

Gastric Electrical Stimulation Is Safe and Effective: A Long-Term Study in Patients with Drug-Refractory Gastroparesis in Three Regional Centers

Driving Gastric Electrical Activity with Electrical Stimulation

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