Lin Z Y, McCallum R W, Schirmer B D, Chen J D
University of Virginia Health Science Center, Charlottesville 22908, USA.
Am J Physiol. 1998 Jan;274(1):G186-91. doi: 10.1152/ajpgi.1998.274.1.G186.
The aim of this study was to investigate the effect of pacing parameters on the entrainment of gastric slow waves in patients with gastroparesis. Four pairs of cardiac pacing wires were placed on the serosal surface of the stomach in 13 patients with gastroparesis. After a baseline recording for 30 min, gastric pacing was performed in a number of sessions with different effective parameters, each lasting for 30 min. The following parameters were found to be effective for the entrainment of the gastric slow wave: a pacing frequency 10% higher than the intrinsic gastric slow wave frequency (IGF), 300 ms pulse width, and 4 mA pacing amplitude. A reduction of pacing amplitude from 4 to 2 mA and 1 mA reduced the percentage of entrainment of the gastric slow wave to 79 +/- 10% and 50 +/- 11%, respectively. Pacing with a pulse width of 30 or 3 ms was not able to entrain the gastric slow wave in any of the patients. An ectopic pacemaker of tachygastria found in three patients was reversed with gastric pacing. It was concluded that gastric pacing at a frequency up to 10% higher than the IGF and with an amplitude of 4 mA and a pulse width of 300 ms is able to completely entrain the gastric slow wave and normalize gastric dysrhythmias in patients with gastroparesis.
本研究的目的是调查起搏参数对胃轻瘫患者胃慢波夹带的影响。在13例胃轻瘫患者的胃浆膜表面放置四对心脏起搏电极。在进行30分钟的基线记录后，分多次进行具有不同有效参数的胃起搏，每次持续30分钟。发现以下参数对胃慢波夹带有效：起搏频率比固有胃慢波频率（IGF）高10%、脉冲宽度300毫秒和起搏幅度4毫安。起搏幅度从4毫安降至2毫安和1毫安时，胃慢波夹带百分比分别降至79±10%和50±11%。脉冲宽度为30或3毫秒的起搏未能在任何患者中夹带胃慢波。在三名患者中发现的快速胃动异位起搏器通过胃起搏得以逆转。得出的结论是，频率比IGF高10%、幅度为4毫安且脉冲宽度为300毫秒的胃起搏能够完全夹带胃慢波并使胃轻瘫患者的胃心律失常正常化。
