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Effects of Capsule Endoscopy on Cardiac Pacemakers
Submitted 7 December 2004
Accepted after revision 22 April 2005
05 December 2005 (online)
Background and Study Aims: Capsule endoscopy is a new, noninvasive diagnostic technique which enables visualization of the mucosa of the small intestine in physiological conditions and without the need to subject the patient to external radiation. Wireless capsule video endoscopy is contraindicated in patients with a cardiac pacemaker. However, on the basis of the characteristics of the radiofrequency band used by the endoscopic capsule, together with a series of other factors, it is possible that the patient’s use of a pacemaker should not be a contraindication to capsule endoscopy.
Patients and Methods: This work had two phases: an in vitro study, using an interference detector, and an in vivo study involving 20 patients with cardiac pacemakers who showed symptoms or signs that justified a capsule endoscopy investigation.
Results: No interference was observed during the first, in vitro, phase of the study. In the second phase, patients wore a Holter recorder for a mean time of 10 hours, during which the average number of recorded QRS complexes exceeded 30 000. All the pacemakers functioned normally. Interference due only to myopotentials was detected in a single patient in whom modification of the pacemaker programming was necessary. In the other 19 patients, neither sensing nor stimulation failures were observed.
Conclusions: No interference between the pacemaker and the endoscopic capsule was observed. All the pacemakers functioned normally, and no increased incidence of adverse effects was observed. Neither was any pacemaker-induced interference observed on the capsule endoscopy images.
- 1 Eliakim R, Fischer D, Suissa A. et al . Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease. Eur J Gastroenterol Hepatol. 2003; 15 363-367
- 2 Saurin J C, Delvaux M, Gaudin J L. et al . Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy. 2003; 35 576-584
- 3 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature. 2000; 405 725-729
- 4 Toivonen L, Valjus J, Hongisto M. et al . The influence of elevated 50 Hz electric and magnetic fields on implanted cardiac pacemakers: the role of the lead configuration and programming of the sensitivity. PACE. 1991; 14 2114-2122
- 5 Bernstein A D, Parsonnet V. Survey of cardiac pacing and implanted defibrillator practice patterns in the United States in 1997. PACE. 2001; 24 842-855
- 6 Hayes D L. Electromagnetic interference and implantable devices. Cardiac Pacing. 2000; 45 365-371
- 7 Hayes D L, Wang P J, Reynolds D W. et al . Interference with cardiac pacemakers by cellular telephones. N Engl J Med. 1997; 336 1473-1479
- 8 Chauvin M, Crenner F, Brechenmacher C. Interaction between permanent cardiac pacing and electrocautery: the significance of electrode position. PACE. 1992; 15 2029-2033
9 Levine P A.
Effect of cardioversion and defibrillation on implanted cardiac pacemakers.In: Barold SS (ed) Modern cardiac pacing. Mount Kisco, New York; Futura Publishing 1985: 875-886
- 10 Dick A J, Jones D L, Klein G J. Effects of RF energy delivery to pacing and defibrillation leads. PACE. 2001; 24 658
- 11 Fetter J, Patterson D, Aram G. et al . Effects of extracorporeal shock wave lithotripsy on single chamber rate response and dual chamber pacemakers. PACE. 1989; 12 1494-1501
- 12 Guyomar Y, Vaudeville L, Heuls S. et al . Interference between pacemaker and video capsule endoscopy. Pacing Clin Electrophysiol.. 2004; 27 1329-1330
- 13 Leighton J A, Sharma V K, Srivathsan K. et al . Safety of capsule endoscopy in patients with pacemakers. Gastrointest Endosc.. 2004; 59 567-569
- 14 Lewis B S. Small intestine bleeding. Gastroenterol Clin N Am. 2000; 29 67-95
G. Payeras, M. D.
Department of Digestive Diseases · Division of Endoscopy · Hospital San Francisco de Asís
Joaquín Costa 28 · Madrid 28002 · Spain