Case Report: Electrical Stimulation at a Frequency Higher than Basal Rate in Human Stomach

Electrical stimulation, or pacing of the stomach has been advocated as a possible treatment for gastric motor dysfunction (1± 11). The rationale stems from the important role played by the electrical control activity (ECA) component of gastric electrical activity (GEA). To date, researchers have employed frequencies similar to, or slightly higher than the native ECA frequency in gastric stimulation (1± 11). In another study, we demonstrated a comparative superiority of high-frequency (ie, several times the basal rate) gastric electrical stimulation (GES) over low-frequency (similar to the basal rate) stimulation in the canine stomach (12). In that study, GES at 20 cycles/min elicited the largest motility index in canine stomach of all the frequencies tested. Compared with the nominal canine ECA frequency of 5 cycles/min, this implies a frequency of approximately four times the physiologic rate. In the present study, we elected a similar higher than physiologic frequency signal to investigate the ef® cacy of GES in improving gastric emptying and symptoms in a patient with refractory diabetic gastroparesis. We chose a pacing signal of 12 cycles/min, approximately four times the nominal physiologic frequency of 3 cycles/min in the human stomach. CASE REPORT