Endoscopic mapping of bioelectric slow waves in the gastric antrum

Abstract

Gastric motility is coordinated, in part, by rhythmic bioelectrical events called slow waves. Dysrhythmic slow waves have been associated with several motility disorders. The current methods for classifying gastric dysrhythmias, via direct-organ mapping, are surgically invasive. To address this limitation, we designed and constructed a minimally invasive, custom gastric mapping device primarily consisting of a 64-electrode spherical-basket mapping catheter, fitted with an internal balloon, which is delivered endoscopically. We successfully deployed this device in n = 13 volunteers, detecting slow waves in n = 12 volunteers, which presented with properties in-line with established physiological ranges confirming device effectiveness. Spatiotemporal propagation maps with >33% electrode coverage were generated in n = 5 volunteers and showed predominantly dysrhythmic activity. This study presents an endoscopic, minimally invasive, high-resolution electrical mapping device complete with first-in-human data from the gastric antrum. With further development, this device could be used to profile and localize gastric dysrhythmias, as a diagnostic tool, and to guide emerging treatments.