Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T22:20:27.290Z Has data issue: false hasContentIssue false
  • English
  • Français

Electrocardiogram Artifacts Caused by Deep Brain Stimulation

Published online by Cambridge University Press:  02 December 2014

Constantine Constantoyannis  and
Brett Heilbron
Constantine Constantoyannis
Affiliation:
Divisions of Neurosurgery, University of British Columbia, Vancouver, Canada
Brett Heilbron
Affiliation:
Division of Cardiology, University of British Columbia, Vancouver, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

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.

Methods:

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, tremor, 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.

Results:

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.

Conclusion:

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.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 3 , August 2004 , pp. 343 - 346
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Limousin, P, Speelman, D, Gielen, F, et al.Multicentre European study of thalamic stimulation in parkinsonian and essential tremor. J Neurol Neurosurg Psychiatry 1999; 66: 289–296.CrossRefGoogle ScholarPubMed
2.Kimberly, APS, Soni, N, Williams, TR.Transcutaneous nerve stimulation and the electrocardiograph. Anesth Intensive Care 1987; 15: 358–359Google Scholar
3.Sliwa, JA, Marinko, MS.Transcutaneous electrical nerve stimulator induced electrocardiogram artifact. Am J Phys Med Rehab 1996; 75: 307–309.CrossRefGoogle ScholarPubMed
4.Knight, BP, Pelosi, F, Michaud, GF, et al.Clinical consequences of electrocardiographic artifact mimicking ventricular tachycardia. N Engl J Med 1999; 341: 1270–1274.Google Scholar
5.Martin, WA, Camenzind, E, Burkhard, PR.ECG artifact due to deep brain stimulation. Lancet 2003; 361(9367): 1431.Google Scholar
6.Siddiqui, MA, Khan, IA.Differential electrocardiographic artifact from implanted spinal cord stimulator. Int J Cardiol 2003, 87: 307–309.CrossRefGoogle ScholarPubMed
7.Berk, C, Carr, J, Sinden, M, et al.Thalamic deep brain stimulation for the treatment of tremor due to multiple sclerosis: a prospective study of tremor and quality of life. J Neurosurg 2002; 97: 815–820.Google Scholar
8.Pollak, P, Benabid, AL, Krack, P, et al.Deep brain stimulation. In: Jancovic, J, Tolosa, E, (Eds). Parkinson’s Disease and Movement Disorders. Baltimore: Williams & Wilkins, 1998: 1085–1101.Google Scholar
9.Benabid, AL, Pollak, P, Gervason, C, et al.Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 1991; 337: 403–406.Google Scholar
10.Limousin, P, Krack, P, Pollak, P, et al.Electrical stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 1998; 339: 1105–1111.Google Scholar
11.Kumar, R, Dagher, A, Hutchinson, WD, et al.Globus pallidus deep brain stimulation for generalized dystonia: clinical and PET investigation. Neurology 1999; 53: 871–874.CrossRefGoogle ScholarPubMed
12.Bebabid, A, Benazzouz, A, Hoffmann, D, et al.Long-term electrical inhibition of deep brain targets in movement disorders. Mov Disord 1998; 13(Suppl 3): 119–125.Google Scholar
13.Bendok, B, Levy, R.Brain stimulation for persistent pain management. In: Gildenberg, P, Tasker, P, (Eds). Textbook of Stereotactic and Functional Neurosurgery. New York: McGraw-Hill Inc., 1998: 1539–1546.Google Scholar