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© Georg Thieme Verlag KG Stuttgart · New York
Capsule endoscopy and cardiac pacemakers: investigation for possible interference
submitted 18 April 2007
accepted after revision 27 September 2007
07 December 2007 (online)
Background and study aims: The diagnostic benefit of capsule endoscopy in suspected small-bowel disease is high and seems to be superior to that with conventional methods and scintigraphy. Because of the limited clinical experience in patients with cardiac pacemakers and other implanted electrical devices, it is recommended that capsule endoscopy should not be used in such cases. We investigated the potential for capsule endoscopy to interfere with cardiac pacemakers in vitro.
Material and methods: 21 different pacemakers and leads were positioned in a 0.9 % saline solution in a tank. Pin jacks were placed that were in contact with the solution. The pacemaker impulse was recorded and an inhibiting signal could be coupled in. The capsules (Given Imaging and Olympus) were placed in different positions relative to the cardiac pacemaker and finally placed on the case of the pacemaker, for 1 minute in each site. The functioning of the pacemaker was observed continuously. The effect on the pacemaker was noted particularly as inhibition, synchronization, or no effect. The pacemaker was then inhibited using a standard test signal.
Results: There was no interference between the video capsule and the cardiac pacemakers in our experiment in spite of the close proximity of the two devices.
Conclusion: The clinical use of capsule endoscopy is unproblematic in patients with cardiac pacemakers.
- 1 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature. 2000; 405 417
- 2 Costamagna G, Shah S K, Riccioni M E. et al . A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology. 2002; 123 999-1005
- 3 Ell C, Remke S, May A, Helou L. et al . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy. 2002; 34 685-689
- 4 Hara A K, Leighton J A, Sharma V K, Fleischer D E. Small bowel: preliminary comparison of capsule endoscopy with barium study and CT. Radiology. 2004; 230 260-265
- 5 Pennazio M, Santucci R, Rondonotti E. et al . Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology. 2004; 126 643-653
- 6 Rösch T, Ell C. Position paper on capsule endoscopy for the diagnosis of small bowel disorders. Z Gastreoenterol.. 2004; 42 247-259
- 7 Vorderholzer W A, Ortner M, Rogalla P. et al . Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis. Endoscopy. 2003; 35 1009-1014
- 8 Zuckerman G R, Prakash C, Askin M P, Lewis B S. A technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 2000; 118 201-221
- 9 Guyomar Y, Vaudeville L, Heuls S. et al . Interference between pacemaker and video capsule endoscopy. Pacing Clin Electrophysiol. 2004; 27 1329-1330
- 10 Leighton J A, Sharma V K, Srivathsan K. et al . Safety of capsule endoscopy in patients with pacemakers. Gastrointest Endosc. 2004; 59 567-569
- 11 Irnich W, Batz L, Müller R, Tobisch R. Electromagnetic interference of pacemakers by mobile phones. PACE. 1996; 19 1431-1446
- 12 CENELEC .EN50 061: 1988/A1: 1995. Safety of implantable cardiac pacemakers: Protection against electrical magnetic interference. Central Secretariat, rue de Stassart 35, B-1650 Brussels
- 13 Payeras G, Piqueras J, Moreno V J. et al . Effects of capsule endoscopy on cardiac pacemakers. Endsocopy. 2005; 37 1181-1185
- 14 Hofgärtner F, Müller T, Sigel H. Können Mobil-Telefone im C-und D-Netz Herzschrittmacher-Patienten gefährden?. Dtsch Med Wschr. 1996; 121 646-652
- 15 Kaden F. Ventricular tachycardia by magnet application during pacemaker check-up. Herzschrittmacher. 1986; 6 37-38
- 16 Barbaro V, Bartolini P, Donato A, Militelo C. Electromagnetic interference of analog cellular phones with pacemakers. Pacing Clin Electrophysiol. 1996; 19 1410-1418
- 17 Dubner S, Dubner Y, Gallino S. et al . Electromagnetic interference with implantable cardiac pacemakers by video capsule. Gastrointest Endosc. 2005; 61 250-254
- 18 Wilke A, Grimm W, Funck R, Maisch B. Influence of D-net (European GSM-Standard) cellular phones on pacemaker function in 50 patients with permanent pacemakers. Pacing. Clin Electrophysiol. 1996 Oct; 19 1456-1458
- 19 Bandorski D, Diehl K L, Jaspersen D. Kapselendoskopie bei Herzschrittmacher-Patienten: aktueller Stand in Deutschland. Z Gastroenterol. 2005; 43 715-718
D. Bandorski, MD
Medizinische Klinik 1