title: Technical note: Evaluation of tined endoscopically placed mucosal leads for temporary gastric neurostimulation.
abstract: OBJECTIVE
  To compare larger diameter corkscrew-tined leads with previously described intracardiac pacing leads for temporary gastric neurostimulation in a canine model.
  
  
  METHODS
  Two mongrel dogs underwent gastroscopy under general anesthesia, with endoscopic placement of two cardiac leads (1 mm tine diameter, 4 mm depth) placed sequentially in 1) transverse configuration in the distal antrum mucosa; 2) longitudinal (1 cm apart) configuration in gastric corpus. Stomach was then stimulated with maximal parameters to induce neutrally mediated contraction. Procedures were then repeated with larger leads (5 mm tine diameter, 8 mm length). Gastric contractions were measured with serosal strain transducers.
  
  
  RESULTS
  Leads were placed endoscopically without difficulty. Neither lead type punctured through to the serosa of the stomach. Neither cardiac nor larger leads were capable of eliciting any gastric contractile activity with endoscopic placement either in the transverse or longitudinal orientations.
  
  
  CONCLUSIONS
  While successful on the serosal side, both the cardiac leads and the larger alternative leads failed to produce stomach contraction when implanted mucosally. This may be due to the elastic nature of the mucosa, which was observed to twist around both types of leads significantly, hindering proper penetration into the muscularis.
  
  
  CONCLUSIONS
  These results suggest that the current concept of temporary gastric electrical neurostimulation via a mucosal approach must be reevaluated, as the procedure most likely does not accurately mimic electrical stimulation in the muscularis.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Mintchev
authors.forename: Alvaro
authors.initials: A
authors.lastname: Arriagada
authors.forename: Martin P
authors.initials: MP
authors.lastname: Mintchev
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Andrews
mesh_terms: D000818:Animals; D004285:Dogs; D004599:Electric Stimulation Therapy / Q000295:instrumentation* / Q000379:methods; D004567:Electrodes, Implanted; D005260:Female; D005753:Gastric Mucosa / Q000502:physiology*; D005773:Gastroscopy / Q000295:instrumentation* / Q000379:methods