PubMed Health⌕ Search

PubMed · 2926464

Interference of automated electroencephalographic processing by an endocardial pacemaker.

Abstract

This article reports a patient with an endocardial pacemaker undergoing a carotid endarterectomy in whom cerebral function was monitored by using processed electroencephalography (EEG). The EEG was processed by means of aperiodic analysis. The pacemaker generated an artifact that was identified on the processed EEG display and on the raw EEG display. During the time of carotid cross-clamping, a loss of EEG activity was noted on careful examination of the processed EEG and confirmed by referring to the raw EEG. Nevertheless, because of the presence of the artifact, the activity edge remained essentially constant despite the change in underlying EEG activity. The cross-clamp was released based on the observed change in EEG activity, yielding a return to baseline EEG activity. The surgeon elected to shunt the patient. The patient awoke without neurologic sequelae. This case serves to demonstrate the importance of referring to the raw EEG signal and the limitations of the activity edge in the presence of artifact.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

S Clark, M Goldberg, R Gorman, A Gerwer. 1989. Interference of automated electroencephalographic processing by an endocardial pacemaker.. https://doi.org/10.1007/bf01618366

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Imaging by multiple modalities of patients with a carotidynia syndrome.

The purpose of this article is to familiarize readers with the clinical syndrome of carotidynia. In the past, the International Headache Society (IHS) described idiopathic carotidynia as a diagnostic entity consisting of a self-limiting neck pain syndrome and tenderness over the carotid bifurcation without structural abnormality and then recently removed it from its classification. Although the clinical criteria of carotidynia in the former classification of the IHS included the absence of structural abnormality, several publications have demonstrated associated radiological findings and have described the usefulness of radiological investigations in diagnosing this syndrome. In this paper, we report four additional cases with a carotidynia clinical syndrome (according to the former classification) and the presence of abnormal soft tissue infiltration surrounding the symptomatic carotid artery as demonstrated by multiple imaging modalities, without any other underlying cause for the carotid pain syndrome. Our findings support the hypothesis that carotidynia could be a distinct disease entity, possibly caused by inflammation.

Carotid Artery Diseases↗

Treatment of carotid artery disease: stenting or surgery.

Carotid endarterectomy (CEA) is the only form of cerebral revascularization for which Level 1 evidence of effectiveness has been reported. Recent studies demonstrate the feasibility of carotid artery stenting (CAS) as an alternative to CEA. Its popularity is due to the perceived advantages of a less invasive treatment for carotid occlusive disease. Two randomized trials have reported no difference in the composite stroke, death, and myocardial infarction rate between CAS and CEA. However, these trials were not powered to identify superiority between the two procedures. A trial sponsored by the National Institutes of Health is currently underway to make that determination. The lead-in phase of this trial noted low complication rates with CAS. These results have encouraged the US Food and Drug Administration to approve the use of CAS in patients with neurologic symptoms (ie, ipsilateral stroke, transient ischemic attacks, and amaurosis fugax) in association with severe medical co-morbidities. Patients with carotid restenosis after previous CEA, anatomically inaccessible lesions above C2, and radiation-induced stenoses may also benefit from preferential treatment with CAS. The National Institutes of Health have now expanded the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) to include asymptomatic patients, and resulting data will help to clarify the role of CAS in this subset as well.

Carotid Artery Diseases↗