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• W2913319992 abstract "Introduction: Gastric electrical stimulation has been approved by the FDA as a humanitarian device exemption in patients with refractory symptoms of gastroparesis of diabetic or idiopathic etiology in 2000. Their interaction with other devices mainly cardiac defibrillators has not been studied.Figure: Gastric electrical stimulation impulses captured by ECG.Case Presentation: A 35 year old man presented multiple times to the emergency department with intractable nausea, vomiting and severe abdominal pain. Patient's vital signs were normal. On physical exam, patient was noted to have temporal wasting and cachexia. Patient was admitted to the hospital where he underwent a small bowel fluoroscopic series that showed significant delays in gastric emptying. CT abdomen was normal and upper endoscopy revealed retained food in the stomach. Biopsy from the stomach was normal and negative for Helicobacter pylori. Due to severe malnutrition and a failed trial of medical therapy, he underwent laparoscopic placement of a gastric electrical stimulator (GES). After the procedure, the patient had an ECG done. Discussion: This young man did not have a pacemaker, however the ECG had captured small spikes which resembled pacemaker discharges. On further examination, the spikes were noted to be of low amplitude and occurred every 4 seconds with 14 spikes each time. This type of phenomenon has been previously described in the literature and is attributed to ECG captured impulses from the gastric electrical stimulator. This entity becomes clinically significant if the patient ever has need for an implantable cardioverter defibrillator (ICD). The spikes produced by the gastric electrical stimulator may be incorrectly recorded as normal sinus rhythm by the ICD while the patient is in a correctable life threatening arrhythmia resulting in failure to fire and death. This is also an example of incorrect automated ECG interpretation of a benign finding and could result in unnecessary and even harmful interventions. Conclusions: External devices such as gastric electrical stimulator systems can result in unusual electrical patterns visible on ECG. Though there is limited data about the interaction between gastric electrical systems and cardiac devices, it is an area that requires further exploration and investigation to prevent negative outcomes.Hopefully further guidelines will be developed to help aid decision making in regards of placement of these devices in patients that may require cardiac devices in the future." @default.
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• W2913319992 date "2017-10-01" @default.
• W2913319992 modified "2023-10-14" @default.
• W2913319992 title "Gastric Pacemaker: An Abnormal ECG" @default.
• W2913319992 doi "https://doi.org/10.14309/00000434-201710001-02558" @default.
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