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rechargeable_deep_brain_stimulation_implantable_pulse_generator

Rechargeable deep brain stimulation implantable pulse generator

The Activa PC implantable pulse generator (IPG) demonstrates a significantly reduced battery life of 2.1 years, with a median battery life of 4.5 years in comparison to 6.6 years in the Kinetra IPG. Future technology developments should therefore be focused on improving the battery life of the newer IPG systems 1).

Nonrechargeable deep brain stimulation implantable pulse generators (IPGs) for movement disorders require surgical replacement every few years due to battery depletion. Rechargeable IPGs reduce frequency of replacement surgeries and inherent risks of complications but require frequent recharging 2).

Rechargeable deep brain stimulation implantable pulse generator for movement disorders are well received by patients as initial therapy and after conversion. Mild reduction in stimulation parameters might be allowed after conversion to RC IPG 3).

However, there is now a choice between fixed-life and rechargeable batteries, with each having their own advantages and disadvantages.

Most patients in a adult cohort with movement disorders chose the fixed-life battery. The better lifestyle associated with a fixed-life battery is a major factor influencing their choice. Rechargeable batteries may be more acceptable if the recharging process is improved, more convenient, and discreet 4).


Mitchell et al., evaluated patient experience with rechargeable IPGs and define predictive characteristics for higher satisfaction.

They contacted all patients implanted with rechargeable IPGs at a single center in a survey-based study. They analyzed patient satisfaction with respect to age, diagnosis, target, charging duration, and body mass index. They tabulated hardware-related adverse events.

Dystonia patients had significantly higher satisfaction than Parkinson's disease patients in recharging, display, programmer, and training domains. Common positive responses were “fewer surgeries” and “small size.” Common negative responses were “difficulty finding the right position to recharge” and “need to recharge every day.” Hardware-related adverse events occurred in 21 of 59 participants.

Patient experience with rechargeable IPGs was largely positive; however, frustrations with recharging and adverse events were common. Dystonia diagnosis was most predictive of high satisfaction across multiple categories, potentially related to expected long disease duration with need for numerous IPG replacements 5).


Hitti et al., implanted rechargeable stimulators in 206 patients undergoing DBS surgery, and demonstrated the cost-effectiveness and high patient satisfaction associated with this procedure 6).

References

1)
Fisher B, Kausar J, Garratt H, Hodson J, White A, Ughratdar I, Mitchell R. Battery Longevity Comparison of Two Commonly Available Dual Channel Implantable Pulse Generators Used for Subthalamic Nucleus Stimulation in Parkinson's Disease. Stereotact Funct Neurosurg. 2018;96(3):151-156. doi: 10.1159/000488684. Epub 2018 Jun 19. PubMed PMID: 29920479.
2) , 5)
Mitchell KT, Volz M, Lee A, San Luciano M, Wang S, Starr PA, Larson P, Galifianakis NB, Ostrem JL. Patient Experience with Rechargeable Implantable Pulse Generator Deep Brain Stimulation for Movement Disorders. Stereotact Funct Neurosurg. 2019 Jul 9:1-7. doi: 10.1159/000500993. [Epub ahead of print] PubMed PMID: 31288242.
3)
Waln O, Jimenez-Shahed J. Rechargeable deep brain stimulation implantable pulse generators in movement disorders: patient satisfaction and conversion parameters. Neuromodulation. 2014 Jul;17(5):425-30; discussion 430. doi: 10.1111/ner.12115. Epub 2013 Sep 24. PubMed PMID: 24112630.
4)
Khaleeq T, Hasegawa H, Samuel M, Ashkan K. Fixed-Life or Rechargeable Battery for Deep Brain Stimulation: Which Do Patients Prefer? Neuromodulation. 2019 Jun;22(4):489-492. doi: 10.1111/ner.12810. Epub 2018 Aug 22. PubMed PMID: 30133071.
6)
Hitti FL, Vaughan KA, Ramayya AG, McShane BJ, Baltuch GH. Reduced long-term cost and increased patient satisfaction with rechargeable implantable pulse generators for deep brain stimulation. J Neurosurg. 2018 Sep 1:1-8. doi: 10.3171/2018.4.JNS172995. [Epub ahead of print] PubMed PMID: 30265199.
rechargeable_deep_brain_stimulation_implantable_pulse_generator.txt · Last modified: 2019/07/11 12:05 by administrador