Electrocardiography in a Patient with Deep Brain Stimulation

A 61-year-old male underwent bilateral subthalamic nucleus deep brain stimulation (DBS) for advanced Parkinson’s disease (PD) with motor fluctuations. Two years later, an electrocardiography (ECG) was performed for the evaluation of shortness of breath. The ECG findings were interpreted as abnormal in primary care, prompting referral to cardiology services. Upon review, the ECG showed artefacts from the neurostimulator operating in a unipolar configuration [amplitude 1.4 V, frequency 130 Hz, pulse-width 80 μs] [Figure 1a]. ECG recorded after switching the neurostimulator off [Figure 1b] and in bipolar configuration [Figure 1c] revealed normal tracings.Figure 1: 12-lead electrocardiography obtained in a patient with deep brain stimulation, with the neurostimulator operating in a unipolar configuration (a); neurostimulator switched off (b); neurostimulator operating in a bipolar configuration (c)DBS procedures are routinely performed for an expanding range of neurological and psychiatric disorders. Hence, it is imperative for physicians to be aware of ECG artefacts due to DBS. Temporarily deactivating the neurostimulator or switching to bipolar stimulation eliminates the artefact.[1] Since cardiovascular disease is a leading cause of mortality in PD, correct interpretation of the ECG is exceedingly important in this population. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.