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Electrogastrography (EGG). The POLYGRAM NET ElectroGastroGraphy Application is intended to record, store, view and analyze gastric myoelectrical activity as an aid in the diagnosis of gastrointestinal motility disorders. Electrogastrography (EGG).

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electrogastrography egg
Electrogastrography (EGG)

The POLYGRAM NET ElectroGastroGraphy Application is intended to record, store, view and analyze gastric myoelectrical activity as an aid in the diagnosis of gastrointestinal motility disorders.

electrogastrography egg2
Electrogastrography (EGG)

EGG is a non-invasive technique that permits prolonged and repeated recordings of gastric electrical activity

EGG detects abnormal myoelectrical rhythms, providing an easy way to define motor pathophysiology; it helps doctors to stratify patients and improve confidence in their therapheutic recommendations

objective of egg tests
Objective of EGG tests
  • To access whether and to what degree electrical dysrhytmia of the stomach exist in those patients with symptoms suggestive of a gastric motor abnormality.
  • These symptoms include early satiety after a meal, bloating, epigastric pain, nausea and vomiting
diseases conditions
Diseases (conditions)
  • Gastroparesis
  • Functional Dyspepsisa
  • Nausea & vomitting
major regions of the stomach

Pacemaker

Fundus

Corpus

Pylorus

Antrum

Major Regions of the Stomach
  • The Fundus, provides a reservoir for food allowing it to be accomodated without an excessive increase in intragastric pressure
  • The Corpus, where the enzyme pepsin is produced. The gastric pacemaker is located at the great curvature of the corpus.
  • The Antrum, where the hormone Gastrin is produced and where mixing and grinding of the food takes place
  • The Pylorus,is the valve between the stomach and the duodenum. It helps controling the emptying of the stomach contents into the duodenum

Duodenum

electrogastrography

Pacesetter

Fundus

Corpus

Pylorus

Antrum

Electrogastrography
  • The normal EGG activity is around 3 cpm
  • The gastric pacesetter generates an electrical signal every 20 sec, that travels towards the antrum, and in response to a caloric challenge or drug, creates powerful peristaltic contractions that force antral contents towards the pylorus and assist in grinding and mixing food.

Duodenum

myoelectrical activity

FFT

Direct signal

Preprandial

Power dB

Power dB

200 µV

Postprandial

5 10 Frequency

CPM

5 10 Frequency

CPM

Position of EGG electrodes

Myoelectrical activity

In normal humans we see an increase in overall amplitude after a meal

diseases conditions8
Diseases (conditions)
  • Gastroparesis (A slight degree of gastroparalysis)
  • Functional Dyspepsia ( A range of symptoms associated with food intake)
  • Nausea & vomiting
clinical applications
Clinical applications
  • Non-ulcer functional dyspepsia detected by gastric dysrhythmia
  • Gastroparesis detected by a drop in EGG peak power and/or post-prandial decreased activity in 3 cpm range
  • Monitor efficacy of prokinectic agents
  • Assess the risk of post-operative retching and complications in laparotomy Nissen Fundoplication
egg multi channel analysis
EGG multi-channel analysis
  • Why perform a multi-channel analysis ?
  • Detect whether the pacemaker’s frequency remains constant (coupled) or becomes uncoupled as it propagates down the stomach.
  • Detect whether the power of the signal increases as it migrates to the antrum - suggesting normal contractility in the stomach after a meal or a prokenetic agent
improved diagnostic confidence
Improved diagnostic confidence
  • EGG can select those patients who will respond to prokinetics
  • In combination with gastric emptying scintigraphy test - which gives motor activity results- we can confirm or exclude a gastric motor abnormality and identify or exclude a myoelectrical etiology
spectrum analysis graph egg
Spectrum analysis graph ( EGG)
  • Healthy patient:

Increased signal power/amplitude postprandially

  • Gastroparesis:

No increased signal in response to a solid meal.

The dominant frequency postprandially is abnormal: tachy- and/or bradygastria / dysrythmia

equipment accessories
Equipment & Accessories
  • Polygraf ID® minimum 8 channels
  • EGG main cable
  • 1, 3 or 4 ch. extension cable
  • Ag/AgCl electrodes
  • Skin preparation gel & paste
  • Motion sensor & cable
capture mode
Capture Mode

On line RSA

1’ time period

4 EGG channel

Real time display

Period markers

Preprandial

Meal

Postprandial

RSA:

Running Spectrum Analysis

Motion Sensor Channel

verify
Verify

Preprandial

Postprandial

Meal

Fundus

Corpus

Channel & Graph

selection display

Tools: cut,

graph, Go to.

Add Event

Antrum

Pylorus

clinical view
Clinical View

Normal Patient

matrix view
Matrix View

Normal Patient

unique features i
Unique features (i)
  • Integrated impedance check
    • Tests impedance in less than 5 sec.
    • Step by step on screen guide (skin preparation and electrode placement)
  • Multi-channel analysis
  • Ease of use
    • No calibration
    • Clinical protocol and report
    • POLYGRAM NET software platform
  • State of the art analysis algorithms by Dr. Chen facilitates short term and long term analyses of recorded data
unique features ii
Unique features (ii)
  • Symptom diary
  • Windows 2000™ operating system
  • Real-time on-screen Running Spectrum Analysis during capture facilitates easy artifact detection and removal
customers
Customers
  • Mainstream gastroenterologists
  • Adult gastric emptying specialist
  • Pediatric gastroenterologist
  • Antireflux surgeons
  • GI Physiologists
enterra therapy
Enterra therapy
  • Implantable pacemaker for the stomach
  • A treatment of chronic nausea and vomiting associated with gastroparesis when conventional drug therapies are not effective
competitors
Competitors
  • 3CPM
    • Currently most prominent competitor - distribution via Sandhill
    • Old system, chunky technology, DOS based, EGG only
  • MMS
    • Up to seven channels
    • FFT analysis, DOS based
slide26

Thanks!

FUNCTIONAL DIAGNOSTICS

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