High-resolution entrainment mapping of gastric pacing: a new analytical tool
Gastric pacing has been investigated as a potential treatment for gastroparesis. New pacing protocols are required to improve symptom and motility outcomes; however, research progress has been constrained by a limited understanding of the effects of electrical stimulation on slow-wave activity. This...
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| Veröffentlicht in: | American journal of physiology: Gastrointestinal and liver physiology 2010-02, Vol.298 (2), p.G314-G321 |
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| container_title | American journal of physiology: Gastrointestinal and liver physiology |
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| creator | O'Grady, Gregory Du, Peng Lammers, Wim J E P Egbuji, John U Mithraratne, Pulasthi Chen, Jiande D Z Cheng, Leo K Windsor, John A Pullan, Andrew J |
| description | Gastric pacing has been investigated as a potential treatment for gastroparesis. New pacing protocols are required to improve symptom and motility outcomes; however, research progress has been constrained by a limited understanding of the effects of electrical stimulation on slow-wave activity. This study introduces high-resolution (HR) "entrainment mapping" for the analysis of gastric pacing and presents four demonstrations. Gastric pacing was initiated in a porcine model (typical amplitude 4 mA, pulse width 400 ms, period 17 s). Entrainment mapping was performed using flexible multielectrode arrays ( |
| doi_str_mv | 10.1152/ajpgi.00389.2009 |
| format | Article |
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New pacing protocols are required to improve symptom and motility outcomes; however, research progress has been constrained by a limited understanding of the effects of electrical stimulation on slow-wave activity. This study introduces high-resolution (HR) "entrainment mapping" for the analysis of gastric pacing and presents four demonstrations. Gastric pacing was initiated in a porcine model (typical amplitude 4 mA, pulse width 400 ms, period 17 s). Entrainment mapping was performed using flexible multielectrode arrays (</=192 electrodes; 92 cm(2)) and was analyzed using novel software methods. In the first demonstration, entrainment onset was quantified over successive waves in spatiotemporal detail. In the second demonstration, slow-wave velocity was accurately determined with HR field analysis, and paced propagation was found to be anisotropic (longitudinal 2.6 +/- 1.7 vs. circumferential 4.5 +/- 0.6 mm/s; P < 0.001). In the third demonstration, a dysrhythmic episode that occurred during pacing was mapped in HR, revealing an ectopic slow-wave focus and uncoupled propagations. In the fourth demonstration, differences were observed between paced and native slow-wave amplitudes (0.24 +/- 0.08 vs. 0.38 +/- 0.14 mV; P < 0.001), velocities (6.2 +/- 2.8 vs. 11.5 +/- 4.7 mm/s; P < 0.001), and activated areas (20.6 +/- 1.9 vs. 32.8 +/- 2.6 cm(2); P < 0.001). Entrainment mapping enables an accurate quantification of the effects of gastric pacing on slow-wave activity, offering an improved method to assess whether pacing protocols are likely to achieve physiologically and clinically useful outcomes.</description><identifier>ISSN: 0193-1857</identifier><identifier>EISSN: 1522-1547</identifier><identifier>DOI: 10.1152/ajpgi.00389.2009</identifier><identifier>PMID: 19926815</identifier><identifier>CODEN: APGPDF</identifier><language>eng</language><publisher>United States: American Physiological Society</publisher><subject>Anatomy & physiology ; Animals ; Effects ; Electric Stimulation - methods ; Electrodes, Implanted ; Female ; Gastric Emptying - physiology ; Gastrointestinal diseases ; Gastroparesis - physiopathology ; Innovative Methodology ; Male ; Medical treatment ; Microelectrodes ; Models, Animal ; Porcine Reproductive and Respiratory Syndrome ; Stomach - physiology ; Studies</subject><ispartof>American journal of physiology: Gastrointestinal and liver physiology, 2010-02, Vol.298 (2), p.G314-G321</ispartof><rights>Copyright American Physiological Society Feb 2010</rights><rights>Copyright © 2010 the American Physiological Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-47eab7d83736907c50805ab8f3090e70809e02efb8a8cb9c6668ace0f78dedb93</citedby><cites>FETCH-LOGICAL-c422t-47eab7d83736907c50805ab8f3090e70809e02efb8a8cb9c6668ace0f78dedb93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3026,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19926815$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Grady, Gregory</creatorcontrib><creatorcontrib>Du, Peng</creatorcontrib><creatorcontrib>Lammers, Wim J E P</creatorcontrib><creatorcontrib>Egbuji, John U</creatorcontrib><creatorcontrib>Mithraratne, Pulasthi</creatorcontrib><creatorcontrib>Chen, Jiande D Z</creatorcontrib><creatorcontrib>Cheng, Leo K</creatorcontrib><creatorcontrib>Windsor, John A</creatorcontrib><creatorcontrib>Pullan, Andrew J</creatorcontrib><title>High-resolution entrainment mapping of gastric pacing: a new analytical tool</title><title>American journal of physiology: Gastrointestinal and liver physiology</title><addtitle>Am J Physiol Gastrointest Liver Physiol</addtitle><description>Gastric pacing has been investigated as a potential treatment for gastroparesis. New pacing protocols are required to improve symptom and motility outcomes; however, research progress has been constrained by a limited understanding of the effects of electrical stimulation on slow-wave activity. This study introduces high-resolution (HR) "entrainment mapping" for the analysis of gastric pacing and presents four demonstrations. Gastric pacing was initiated in a porcine model (typical amplitude 4 mA, pulse width 400 ms, period 17 s). Entrainment mapping was performed using flexible multielectrode arrays (</=192 electrodes; 92 cm(2)) and was analyzed using novel software methods. In the first demonstration, entrainment onset was quantified over successive waves in spatiotemporal detail. In the second demonstration, slow-wave velocity was accurately determined with HR field analysis, and paced propagation was found to be anisotropic (longitudinal 2.6 +/- 1.7 vs. circumferential 4.5 +/- 0.6 mm/s; P < 0.001). In the third demonstration, a dysrhythmic episode that occurred during pacing was mapped in HR, revealing an ectopic slow-wave focus and uncoupled propagations. In the fourth demonstration, differences were observed between paced and native slow-wave amplitudes (0.24 +/- 0.08 vs. 0.38 +/- 0.14 mV; P < 0.001), velocities (6.2 +/- 2.8 vs. 11.5 +/- 4.7 mm/s; P < 0.001), and activated areas (20.6 +/- 1.9 vs. 32.8 +/- 2.6 cm(2); P < 0.001). Entrainment mapping enables an accurate quantification of the effects of gastric pacing on slow-wave activity, offering an improved method to assess whether pacing protocols are likely to achieve physiologically and clinically useful outcomes.</description><subject>Anatomy & physiology</subject><subject>Animals</subject><subject>Effects</subject><subject>Electric Stimulation - methods</subject><subject>Electrodes, Implanted</subject><subject>Female</subject><subject>Gastric Emptying - physiology</subject><subject>Gastrointestinal diseases</subject><subject>Gastroparesis - physiopathology</subject><subject>Innovative Methodology</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Microelectrodes</subject><subject>Models, Animal</subject><subject>Porcine Reproductive and Respiratory Syndrome</subject><subject>Stomach - physiology</subject><subject>Studies</subject><issn>0193-1857</issn><issn>1522-1547</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1v1DAQxS1ERZfCnROyuHDKdmzHsc0BqaqAIq3EBc7WxOukXiVxsJNW_e9xtyu-TqOZefP0Rj9C3jDYMib5JR7mPmwBhDZbDmCekU0Z84rJWj0nG2BGVExLdU5e5nwAAMkZe0HOmTG80UxuyO4m9LdV8jkO6xLiRP20JAzTWCodcZ7D1NPY0R7zkoKjM7oy-UCRTv6e4oTDwxIcDnSJcXhFzjocsn99qhfkx-dP369vqt23L1-vr3aVqzlfqlp5bNVeCyUaA8pJ0CCx1Z0AA16Vznjgvms1atca1zSNRuehU3rv960RF-Tjk--8tqPfu2Pmwc4pjJgebMRg_91M4db28c5yzXltdDF4fzJI8efq82LHkJ0fBpx8XLNVouZSMeBF-e4_5SGuqbydLRdcaiGgLiJ4ErkUc06--x2FgX0EZY-g7BGUfQRVTt7-_cKfgxMZ8QtRe5C-</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>O'Grady, Gregory</creator><creator>Du, Peng</creator><creator>Lammers, Wim J E P</creator><creator>Egbuji, John U</creator><creator>Mithraratne, Pulasthi</creator><creator>Chen, Jiande D Z</creator><creator>Cheng, Leo K</creator><creator>Windsor, John A</creator><creator>Pullan, Andrew J</creator><general>American Physiological Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100201</creationdate><title>High-resolution entrainment mapping of gastric pacing: a new analytical tool</title><author>O'Grady, Gregory ; Du, Peng ; Lammers, Wim J E P ; Egbuji, John U ; Mithraratne, Pulasthi ; Chen, Jiande D Z ; Cheng, Leo K ; Windsor, John A ; Pullan, Andrew J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-47eab7d83736907c50805ab8f3090e70809e02efb8a8cb9c6668ace0f78dedb93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Anatomy & physiology</topic><topic>Animals</topic><topic>Effects</topic><topic>Electric Stimulation - methods</topic><topic>Electrodes, Implanted</topic><topic>Female</topic><topic>Gastric Emptying - physiology</topic><topic>Gastrointestinal diseases</topic><topic>Gastroparesis - physiopathology</topic><topic>Innovative Methodology</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Microelectrodes</topic><topic>Models, Animal</topic><topic>Porcine Reproductive and Respiratory Syndrome</topic><topic>Stomach - physiology</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Grady, Gregory</creatorcontrib><creatorcontrib>Du, Peng</creatorcontrib><creatorcontrib>Lammers, Wim J E P</creatorcontrib><creatorcontrib>Egbuji, John U</creatorcontrib><creatorcontrib>Mithraratne, Pulasthi</creatorcontrib><creatorcontrib>Chen, Jiande D Z</creatorcontrib><creatorcontrib>Cheng, Leo K</creatorcontrib><creatorcontrib>Windsor, John A</creatorcontrib><creatorcontrib>Pullan, Andrew J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of physiology: Gastrointestinal and liver physiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Grady, Gregory</au><au>Du, Peng</au><au>Lammers, Wim J E P</au><au>Egbuji, John U</au><au>Mithraratne, Pulasthi</au><au>Chen, Jiande D Z</au><au>Cheng, Leo K</au><au>Windsor, John A</au><au>Pullan, Andrew J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-resolution entrainment mapping of gastric pacing: a new analytical tool</atitle><jtitle>American journal of physiology: Gastrointestinal and liver physiology</jtitle><addtitle>Am J Physiol Gastrointest Liver Physiol</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>298</volume><issue>2</issue><spage>G314</spage><epage>G321</epage><pages>G314-G321</pages><issn>0193-1857</issn><eissn>1522-1547</eissn><coden>APGPDF</coden><abstract>Gastric pacing has been investigated as a potential treatment for gastroparesis. New pacing protocols are required to improve symptom and motility outcomes; however, research progress has been constrained by a limited understanding of the effects of electrical stimulation on slow-wave activity. This study introduces high-resolution (HR) "entrainment mapping" for the analysis of gastric pacing and presents four demonstrations. Gastric pacing was initiated in a porcine model (typical amplitude 4 mA, pulse width 400 ms, period 17 s). Entrainment mapping was performed using flexible multielectrode arrays (</=192 electrodes; 92 cm(2)) and was analyzed using novel software methods. In the first demonstration, entrainment onset was quantified over successive waves in spatiotemporal detail. In the second demonstration, slow-wave velocity was accurately determined with HR field analysis, and paced propagation was found to be anisotropic (longitudinal 2.6 +/- 1.7 vs. circumferential 4.5 +/- 0.6 mm/s; P < 0.001). In the third demonstration, a dysrhythmic episode that occurred during pacing was mapped in HR, revealing an ectopic slow-wave focus and uncoupled propagations. In the fourth demonstration, differences were observed between paced and native slow-wave amplitudes (0.24 +/- 0.08 vs. 0.38 +/- 0.14 mV; P < 0.001), velocities (6.2 +/- 2.8 vs. 11.5 +/- 4.7 mm/s; P < 0.001), and activated areas (20.6 +/- 1.9 vs. 32.8 +/- 2.6 cm(2); P < 0.001). Entrainment mapping enables an accurate quantification of the effects of gastric pacing on slow-wave activity, offering an improved method to assess whether pacing protocols are likely to achieve physiologically and clinically useful outcomes.</abstract><cop>United States</cop><pub>American Physiological Society</pub><pmid>19926815</pmid><doi>10.1152/ajpgi.00389.2009</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Physiological Society; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Anatomy & physiology Animals Effects Electric Stimulation - methods Electrodes, Implanted Female Gastric Emptying - physiology Gastrointestinal diseases Gastroparesis - physiopathology Innovative Methodology Male Medical treatment Microelectrodes Models, Animal Porcine Reproductive and Respiratory Syndrome Stomach - physiology Studies |
| title | High-resolution entrainment mapping of gastric pacing: a new analytical tool |
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