Neuromodulation of Gastric Muscle Can Affect the Electrocardiogram: A Case Report
Authors: Maximilian Tiller, Sebastian Reif, Stefan Volz, Wolfgang Schepp, Felix Gundling
Journal: Annals of Internal Medicine (2016)

Letters1 November 2016Neuromodulation of Gastric Muscle Can Affect the Electrocardiogram: A Case ReportMaximilian Tiller, MD, Sebastian Reif, MD, Stefan Volz, MD, Wolfgang Schepp, MD, and Felix Gundling, MDMaximilian Tiller, MDFrom Bogenhausen Academic Teaching Hospital, Munich Municipal Hospital Trust, Munich, Germany.Search for more papers by this author, Sebastian Reif, MDFrom Bogenhausen Academic Teaching Hospital, Munich Municipal Hospital Trust, Munich, Germany.Search for more papers by this author, Stefan Volz, MDFrom Bogenhausen Academic Teaching Hospital, Munich Municipal Hospital Trust, Munich, Germany.Search for more papers by this author, Wolfgang Schepp, MDFrom Bogenhausen Academic Teaching Hospital, Munich Municipal Hospital Trust, Munich, Germany.Search for more papers by this author, and Felix Gundling, MDFrom Bogenhausen Academic Teaching Hospital, Munich Municipal Hospital Trust, Munich, Germany.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0002 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Neuromodulation in visceral medicine involves surgical insertion of a device, placement of electrodes in a neural plexus or the muscle layer of an organ, and delivery of electrical pulses with specific energies and intervals. It is currently used to manage fecal incontinence (by stimulation of the sacral nerve), symptoms of gastroesophageal reflux (by stimulation of the lower esophageal sphincter), and gastroparesis (by stimulation of the neurons in gastric muscle) (1).Objective: To alert clinicians to the possibility that neuromodulation devices can complicate the interpretation of electrocardiograms (ECGs).Case Report: We have 3 patients with severe gastroparesis who have been ...References1. Hasler WL. Methods of gastric electrical stimulation and pacing: a review of their benefits and mechanisms of action in gastroparesis and obesity. Neurogastroenterol Motil. 2009;21:229-43. [PMID: 19254353] doi:10.1111/j.1365-2982.2009.01277.x CrossrefMedlineGoogle Scholar2. Chu H, Lin Z, Zhong L, McCallum RW, Hou X. Treatment of high-frequency gastric electrical stimulation for gastroparesis. J Gastroenterol Hepatol. 2012;27:1017-26. [PMID: 22128901] doi:10.1111/j.1440-1746.2011.06999.x CrossrefMedlineGoogle Scholar3. Reif S, Tiller M, Hoffmann E. Uncommon etiology of abnormal spikes on electrocardiogram. JAMA Intern Med. 2014;174:458-9. [PMID: 24395146] doi:10.1001/jamainternmed.2013.13666 CrossrefMedlineGoogle Scholar4. Reif S, Steiner P, Hoffmann E. Dual implantable electronic device therapy. Europace. 2014;16:1321. [PMID: 25031232] doi:10.1093/europace/euu181 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Bogenhausen Academic Teaching Hospital, Munich Municipal Hospital Trust, Munich, Germany.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0002. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPeriprocedural Considerations for Patients with Gastric Electrical Stimulators 1 November 2016Volume 165, Issue 9Page: 677-678KeywordsDisclosureElectrocardiographyGastroparesisHeart diseasesIncontinenceMusclesNauseaNervesNeuromodulationNeurons ePublished: 1 November 2016 Issue Published: 1 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...