Download PDF
Z Gastroenterol 2013; 51(8): 747-752
DOI: 10.1055/s-0033-1335999
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Kapselendoskopie bei Patienten mit Herzschrittmachern und implantierbaren Cardioverter-Defibrillatoren – Ist die formale Kontraindikation noch gerechtfertigt?

Capsule Endoscopy in Patients with Cardiac Pacemakers and Implantable Cardioverter Defibrillators – Is the Formal Contraindication still Justified?
D. Bandorski
1   Medizinische Klinik 2, Universität Gießen
,
D. Stunder
2   Institut für Arbeits- und Sozialmedizin, Universitätsklinikum Aachen Forschungszentrum für Elektro-Magnetische Umweltverträglichkeit (femu), Aachen
,
R. Höltgen
3   III. Medizinische Klinik – Elektrophysiologie/Rhythmologie, Klinikverbund Westmünsterland – St.-Agnes-Hospital Bocholt-Rhede GmbH, Bocholt
,
R. Jakobs
4   Medizinische Klinik C, Klinikum Ludwigshafen
,
M. Keuchel
5   Klinik für Innere Medizin, Bethesda Krankenhaus Bergedorf, Hamburg
› Author Affiliations
Further Information

Publication History

04 May 2013

10 June 2013

Publication Date:
16 August 2013 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund und Ziele: Die Kapselendoskopie ist ein etabliertes Verfahren zur Untersuchung des Dünndarms. Seitens der US Food and Drug Administration (FDA) und der Hersteller besteht die Empfehlung, die Kapselendoskopie nicht bei Patienten mit Herzschrittmachern oder implantierten Cardioverter-Defibrillatoren einzusetzen.

Methode: Studien zu möglichen Interferenzen zwischen der Dünndarmkapselendoskopie und Herzschrittmachern/Defibrillatoren wurden analysiert. Für diese Übersichtsarbeit dienten in PubMed gelistete Studien in deutscher oder englischer Sprache und aktuelle Abstracts zum Thema sowie Herstellerinformationen als Grundlage.

Ergebnisse: In-vitro- und In-vivo-Studien mit realen Kapseln zeigten keine klinisch relevanten Interferenzen mit Herzschrittmachern und implantierten Cardioverter-Defibrillatoren. Diese Erkenntnisse spiegeln sich bereits in der klinischen Praxis und den Empfehlungen der Fachgesellschaften wider. Eine funkbasierte Telemetrie kann dagegen die Videoaufzeichnung stören.

Schlussfolgerung: Die Dünndarmkapselendoskopie kann nach derzeitigem Kenntnisstand bei Patienten mit Herzschrittmachern/implantierten Cardioverter-Defibrillatoren nach entsprechender Aufklärung über die formal noch bestehende Kontraindikation durchgeführt werden.

Abstract

Background and Aims: Capsule endoscopy is an established tool for investigation of the small intestine. Because of limited clinical experience in patients with cardiac devices the US Food and Drug Administration and the manufacturers recommend not to use capsule endoscopy in these patients.

Methods: Studies investigating possible interference between small bowel capsule endoscopy and cardiac pacemakers and implanted cardioverters were analysed. For the review we considered studies published in English or German and indexed in PubMed (Medline) as well as relevant abstracts and technical data from the manufacturer.

Results: In vitro and in vivo studies applying real capsules revealed no clinically relevant interference with pacemakers and implanted cardioverters. This evidence already has had an impact on clinical practice and recommendations of scientific societies. On the other hand wireless telemetry can interfere with CE video.

Conclusion: According to present evidence, small bowel capsule endoscopy can be used in patients with pacemakers and implanted cardioverters after obtaining informed consent concerning the formal existence of contraindication.

Schlüsselwörter

gastrointestinale Blutung - Dünndarmblutung - Darm - chronische gastrointestinale Blutung - Kapselendoskopie - Dünndarmdiagnostik

Key words

gastrointestinal haemorrhage - small bowel haemorrhage - bowels - chronic gastrointestinal haemorrhage - capsule endoscopy - small bowel diagnostics
 

  • Literatur

  • 1 Dubner S, Dubner Y, Gallino S et al. Electromagnetic interference with implantable cardiac pacemakers by video capsule. Gastrointest Endosc 2005; 61: 250-254
    CrossrefPubMedGoogle Scholar
  • 2 Payeras G, Piqueras J, Moreno VJ et al. Effects of Capsule Endoscopy on Cardiac Pacemakers. Endsocopy 2005; 37: 1181-1185
    PubMedGoogle Scholar
  • 3 Bandorski D, Diehl KL, Jaspersen D et al. Kapselendoskopie und Herzschrittmacher – Ein Modellversuch zur Untersuchung möglicher Interferenzen. Endo heute 2006; 19: 183-187
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Bandorski D, Irnich W, Brueck M et al. Capsule endoscopy and cardiac pacemakers: investigation for possible interference. Endoscopy 2008; 40: 36-39
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Irnich W, Batz L, Müller R et al. Electromagnetic Interference of Pacemakers by Mobile Phones. PACE 1996; 19: 1431-1446
    CrossrefPubMedGoogle Scholar
  • 6 Cuschieri JR, Osman MN, Wong RC et al. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review. World J Gastrointest Endosc 2012; 4: 87-93
    CrossrefPubMedGoogle Scholar
  • 7 Bandorski D, Diehl KL et al. Kapselendoskopie bei Herzschrittmacher-Patienten: aktueller Stand in Deutschland. Z Gastroenterol 2005; 43: 715-718
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Bandorski D, Lotterer E, Hartmann D et al. Capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter-defibrillators – a retrospective Multicenter investigation. J Gastrointestin Liver Dis 2011; 20: 33-37
    PubMedGoogle Scholar
  • 9 Bandorski D, Jakobs R, Brück M et al. Capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: (Re)evaluation of the current state in germany, austria and switzerland 2010. Gastroenterol Res Pract 2012; 2012: 717408
    PubMedGoogle Scholar
  • 10 Dirks MH, Costea F, Seidman EG. Successful video capsule endoscopy in patients with an abdominal cardiac pacemaker. Endscopy 2008; 40: 73-75
    PubMedGoogle Scholar
  • 11 Guyomar Y, Vaudeville L, Heuls S et al. Interference between pacemaker and video capsule endoscopy. Pacing Clin Electrophysiol 2004; 27: 1329-1330
    CrossrefPubMedGoogle Scholar
  • 12 Leighton JA, Sharma VK, Srivathsan K et al. Safety of capsule endoscopy in patients with pacemakers. Gastrointest Endosc 2004; 59: 567-569
    CrossrefPubMedGoogle Scholar
  • 13 Rosenberg LN, Seper PS, Ehri A et al. Safety of capsule endoscopy in patients with an implanted cardiac device. Gastrointest Endosc 2011; 73 (4S) AB 133 (Abstract).
    PubMedGoogle Scholar
  • 14 Korenblit J, Oppong Y, Laura S et al. Wireless capsule endoscopy in patients with implantable cardiac devices. Gastrointest Endosc 2011; 73 (4S): AB 461 (Abstract).
    PubMedGoogle Scholar
  • 15 Dubner S, Dubner Y, Rubio H et al. Electromagnetic Interference from Wireless Video-Capsule Endoscopy on Implantable Cardioverter-Defibrillators. Pacing Clin Electrophysiol 2007; 30: 472-475
    CrossrefPubMedGoogle Scholar
  • 16 Bandorski D, Irnich W, Brück M et al. Do endoscopy capsules interfere with implantable cardioverter-defibrillators?. Endoscopy 2009; 41: 457-461
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Pelargonio G, Russo AD, Pace M et al. Use of video capsule endoscopy in a patient with an implantable cardioverter defibrillator. Europace 2006; 8: 1062-0163
    CrossrefPubMedGoogle Scholar
  • 18 Leighton JA, Srivathsan K, Carey EJ et al. Safety of wireless capsule endoscopy in patients with an implantable cardiac defibrillator. Am J Gastroenterol 2005; 100: 1728-1731
    PubMedGoogle Scholar
  • 19 Girelli CM, Tartara P, Vitali E. Lack of Reciprocal Interference Between Capsule Endoscope and Left Ventricular Asssist Device. Endoscopy 2006; 38: 95
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Garatti A, Bruschi G, Girelli C et al. Small intestine capsule endoscopy in magnetic suspended axial left ventricular device patient. Interactive Cardiovascular and Thoracic Surgery 2006; 5: 1-4
    CrossrefPubMedGoogle Scholar
  • 21 Harris LA, Hansel SI, Rajan E et al. Capsule endoscopy in patients with implanted electromedical cardiac devices: results from the largest series up to date in Proceedings of the 1st International Conference on Capsule and Double Balloon Endoscopy. Paris, France: 2010
    PubMedGoogle Scholar
  • 22 Bang S, Park JY, Jeong S et al. First clinical trial of the “MiRo”capsule endoscope by using a novel transmission technology: electric-field propagation. Gastrointest Endosc 2009; 69: 253-259
    CrossrefPubMedGoogle Scholar
  • 23 Chung JW, Hwang HJ, Chung MJ et al. Safety of capsule endoscopy using human body communication in patient with cardiac devices. Dig Dis Sci 2012;
    PubMedGoogle Scholar
  • 24 Li CY, Zhang BL, Chen CX et al. OMOM capsule endoscopy in diagnosis of small bowel disease. J Zhejiang Univ Sci B 2008; 9: 857-862
    CrossrefPubMedGoogle Scholar
  • 25 Sieg A, Gehrke SG. A newly developed small bowel capsule endoscope with panoramic imaging and improved detection of the duodenal papilla. Gastrointest Endosc 2011; 73 (Suppl): AB380-AB381 (abstract).
    PubMedGoogle Scholar
  • 26 Eliakim R, Yassin K, Niv Y et al. Prospective multicenter performance evaluation of the second-generation colon capsule compared with colonoscopy. Endoscopy 2009; 41: 1026-1031
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 May A, Albert J, Keuchel M et al. Kapselendoskopie in der Diagnostik von Dünndarmerkrankungen Update des Positionspapiers der Sektion Endoskopie der DGVS, Stand 07/2010 (Capsule endoscopy for the diagnosis of small bowel diseases. An updated statement by the endoscopy section of DGVS). Z Gastroenterol 2010; 48: 1384-1404
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Ladas SD, Triantafyllou K, Spada C et al. European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy 2010; 42: 220-227
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 E DIN VDE 0848-3-1. Ausgabe: 2002-05; Sicherheit in elektrischen, magnetischen und elektromagnetischen Feldern Teil 3-1: Schutz von Personen mit aktiven Körperhilfsmitteln im Frequenzbereich 0 Hz bis 300 GHz.
    PubMedGoogle Scholar