Differential electrocardiographic artifact from implanted spinal cord stimulator

Siddiqui, Mumtaz A.; Khan, Ijaz A.

doi:10.1016/s0167-5273(02)00355-8

Cited by 17 publications

(17 citation statements)

References 5 publications

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“…12,13 In the first case, percutaneous electrodes placed at C2-3 allowed pain medication to be discontinued before conception; the patient conceived and delivered a full term infant by normal vaginal delivery with the stimulator remaining on throughout labour. [18][19][20] Deactivating the IPG before ECG monitoring will avoid this interference. Subcutaneous extension wires were placed paraspinally from the cervical region to a buttock IPG.…”

Section: Discussionmentioning

confidence: 99%

Caesarean section in a parturient with a spinal cord stimulator

Sommerfield

O’Keeffe

et al. 2010

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Caesarean section in a parturient with a spinal cord stimulator

Sommerfield

O’Keeffe

et al. 2010

International Journal of Obstetric Anesthesia

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“…There is little guidance available regarding the perioperative anesthetic management of patients with SCS, but experience with deep brain stimulators, which use a similar technology, may be relevant [15-17]. Artifacts on electrocardiography have been noted during SCS, deep brain stimulation and transcutaneous nerve stimulation [18]. The current location of the electrode, lead extender and generator is ascertained by previous radiographs to assess the need for any special measures if neuraxial anesthesia is indicated.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy in Woman with Spinal Cord Stimulator for Complex Regional Pain Syndrome: A Case Report and Review of the Literature

et al. 2010

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Spinal cord stimulation (SCS) is used to manage chronic pain syndromes and it is accepted a cost-effective therapy. Child-bearing women who had SCS become or choose to become pregnant despite these policies pregnancy is a relative contraindication. A 32-year-old woman had SCS as a treatment for the CRPS I of the left lower extremity. During various check up tests, we happen to find out that her serum beta-hCG was positive and confirmed pregnancy. SCS is not recommended in pregnancy because the effects of SCS on pregnancy and nursing mothers had not been confirmed. However, many female patients suffering from chronic pain may expect future pregnancy and we think that they must be informed about the possibility of pregnancy and the effects of SCS device implantation in the course of pregnancy. First of all, a good outcome requires a multidisciplinary team approach, including obstetrics, neonatology, pain medicine and anesthesia, as was used from an early pregnancy. Unfortunately, she had a misabortrion after 6 weeks.

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“…[7][8][9] Artifacts on the ECG produced by deep brain stimulation and spinal cord stimulation have been reported recently. 10,11 In the case of DBS, the electrical interference appears to be only evident on the ECG when the stimulator is operating in the monopolar mode. The electrical current is traveling between the contact in the brain (cathode) and the generator below the clavicle (anode) and is of suff i c i e n t magnitude to be recorded by the ECG machine.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiogram Artifacts Caused by Deep Brain Stimulation

Constantoyannis

Heilbron

Honey³

2004

Can. j. neurol. sci.

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Deep brain stimulation (DBS) has been demonstrated to be very effective and is increasingly used worldwide for the treatment of Parkinson's disease, dystonia, tremor and intractable pain. [1][2][3][4][5][6] The components used for DBS include an electrode placed stereotactically into the appropriate brain target, an implantable neural stimulator (INS) typically placed subcutaneously below the clavicle and a connecting wire which joins them. The INS functions as a pacemaker and delivers high frequency electrical pulses to the brain target. Our typical stimulation parameters are 130-185 Hz, 90-120 µs pulse width, A B S T R A C T: B a c k g r o u n d : Deep brain stimulation (DBS) is increasingly used to treat a variety of neurological conditions (e.g. movement disorders and chronic pain). This prospective study was designed to detect electrocardiogram (ECG) artifacts induced by deep brain stimulation and to investigate which factors (patient disease, electrode position within the brain or type of stimulation) produced these artifacts. M e t h o d s : Twelve patients (four women, eight men) with deep brain stimulators were enrolled in the study. Patients were selected to represent the common indications for DBS (Parkinson's disease, t r e m o r, dystonia), the common electrode locations (pallidum, thalamus, subthalamic nucleus) and the two types of stimulation (monopolar, bipolar). Patients had one ECG with the DBS turned 'on'and another with the DBS turned 'off'. The ECGs were then randomized and read by a cardiologist blinded to the status of the patient and DBS and artifacts were noted to be either present or absent. R e s u l t s : The six patients using monopolar stimulation all had artifacts on their electrocardiograms. These artifacts were severe enough to interfere with ECG interpretation. There were no artifacts detected in the six patients using bipolar stimulation. Electrode location and patient disease appeared to have no effect on ECG artifact. C o n c l u s i o n s : Deep brain stimulation can cause ECG artifacts when monopolar settings are used. These artifacts are not present with bipolar settings or when the DBS is turned 'off'. Knowledge of these potential ECG artifacts and how to avoid them is essential to facilitate accurate ECG interpretation.RÉSUMÉ: Artefacts électrocartiographiques causés par la stimulation cérébrale profonde. Introduction: La stimulation cérébrale profonde (SCP) est de plus en plus utilisée pour traiter différents problèmes neurologiques (i.e. les désordres du mouvement et la douleur chronique). Cette étude prospective a été conçue pour détecter des artefacts électrocardiographiques induits par la stimulation cérébrale profonde et pour étudier quels facteurs (maladie, position des électrodes dans le cerveau ou type de stimulation) produisent ces artefacts. Méthodes: Douze patients, quatre femmes et huit hommes, ayant un stimulateur cérébral profond, ont été recrutés pour participer à cette étude. Les patients étaient choisis parce qu'ils présentaient les indications usuelle...

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Differential electrocardiographic artifact from implanted spinal cord stimulator

Cited by 17 publications

References 5 publications

Caesarean section in a parturient with a spinal cord stimulator

Caesarean section in a parturient with a spinal cord stimulator

Pregnancy in Woman with Spinal Cord Stimulator for Complex Regional Pain Syndrome: A Case Report and Review of the Literature

Electrocardiogram Artifacts Caused by Deep Brain Stimulation

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