Neurostimulator-induced ECG artefacts: A systematic analysis.

Area of Science:

• Neuroscience
• Cardiology
• Medical Engineering

Background:

• Deep brain stimulation (DBS) is a therapeutic intervention that can interfere with electrocardiogram (ECG) readings.
• Such interference poses diagnostic challenges, especially in emergency situations, potentially leading to inappropriate medical treatment.

Purpose of the Study:

• To investigate factors influencing ECG interpretation in patients with DBS.
• To assess the susceptibility of specific ECG criteria (frequency, rhythm, regularity, QRS-configuration, ST-segment) to neurostimulation.

Main Methods:

• Prospective study involving 33 DBS patients undergoing ECGs with activated and deactivated stimulation.
• ECGs recorded using limb, 12-channel, Nehb, and paddle leads with three different ECG devices.
• Statistical analysis using regression and maximum likelihood estimation.

Main Results:

• Monopolar DBS settings significantly interfered with ECG recordings more than bipolar settings (p < 0.0001).
• Deactivating bipolar stimulation could worsen ECG quality due to movement artifacts (p < 0.0001).
• Higher neurostimulation voltage negatively correlated with ECG rhythm (p = 0.03) and frequency (p = 0.02) interpretability. Nehb leads provided the highest ECG interpretability.

Conclusions:

• Bipolar neurostimulation minimally affects ECGs and can enhance quality by suppressing motion artifacts.
• For necessary monopolar stimulation, minimizing stimulation voltage is crucial for obtaining interpretable ECGs.