Brief Article
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World J Gastrointest Endosc. Mar 16, 2012; 4(3): 87-93
Published online Mar 16, 2012. doi: 10.4253/wjge.v4.i3.87
Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review
Justin R Cuschieri, Mohammed N Osman, Richard CK Wong, Amitabh Chak, Gerard A Isenberg
Justin R Cuschieri, Division of Gastroenterology, Department of Medicine, Albert Einstein Medical Center, 5401 Old York Road, Klein building suite 363, Philadelphia, PA 19141, United States
Mohammed N Osman, Division of Cardiology, Department of Medicine, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States
Richard CK Wong, Amitabh Chak, Gerard A Isenberg, Division of Gastroenterology and Liver Disease, Department of Medicine, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44016, United States
Author contributions: Cuschieri JR acquired the data and wrote the paper; Osman MN interpreted ECG tracings; Wong RCK, Chak A and Isenberg GA provided subjects for the study; all authors were involved conceptual design and critical revision of the manuscript.
Correspondence to: Dr. Justin R Cuschieri, Division of Gastroenterology, Department of Medicine, Albert Einstein Medical Center, 5401 Old York Road, Klein building, suite 363, Philadelphia, PA 19141, United States. drjrc313@gmail.com
Telephone: +215-456-8210 Fax: +215-456-2494
Received: August 30, 2011
Revised: February 1, 2012
Accepted: March 1, 2012
Published online: March 16, 2012
Abstract

AIM: To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).

METHODS: Authors conducted a chart review of 20 patients with a cardiac pacemaker (CP) or implantable cardioverter defibrillator (ICD) who underwent continuous electrocardiographic monitoring during their SBCE from 2003-2008. authors searched for unexplained electrocardiogram (ECG) findings, changes in CP and ICD set parameters, any abnormality in transmitted capsule data, and adverse clinical events.

RESULTS: There were no adverse events or hemodynamically significant arrhythmias reported. CP and ICD set parameters were preserved. The majority of ECG abnormalities were also found in pre- or post- SBCE ECG tracings and the CP behavior during arrhythmias appeared appropriate. Two patients seemed to have episodes of undersensing by the CP. However, similar findings were documented in ECGs taken outside the time frame of the SBCE. One patient was observed to have a low signal encountered from the capsule resulting in lack of localization, but no images were lost.

CONCLUSION: Capsule-induced EMI remains a possibility but is unlikely to be clinically important. CP-induced interference of SBCE is also possible, but is infrequent and does not result in loss of images transmitted by the capsule.

Keywords: Small bowel capsule endoscopy; Cardiac pacemakers; Implantable cardioverter defibrillators; Electromagnetic interference; Telemetry review