Practical Urodynamics for the Clinician by Andrew C. Peterson & Matthew O. Fraser

Author:Andrew C. Peterson & Matthew O. Fraser
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Physiologic artifact may also interfere with EMG tracings. The most common cause of artifact is the EMG signal generated from the heart. It will take on the pattern of the patients pulse rate. Significant lower extremity spasms as can be seen in patients with neurologic insults can also result in EMG artifact. While these potential sources of artifact can be identified, they usually cannot be removed from the EMG study.

The most common source of artifact is technical factors. These include improper electrode placement and/or improper grounding. This potential source of error can be minimized by proper insertion technique either employing the use of an audio monitor when feasible or by testing placement by having the patient cough or actively recruit pelvic musculature. The clinician should have a low threshold for re-evaluating electrode placement throughout the urodynamic study and replacing and/or repositioning the electrodes as necessary. Another source of technical artifact is voiding across surface EMG electrodes resulting in an increase in EMG signal. Taping of the lead wires in unshielded patches or using shielded patches may help to decrease this potential source of error [4].

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