title: Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices.
abstract: OBJECTIVE
  Implantable cardiac devices are a relative contraindication to video capsule endoscopy (VCE) because of concerns regarding interference. As a result of a lack of alternatives, some centers have adopted protocols to allow for VCE in these patients. There are minimal published descriptions of the gastrointestinal outcomes of these procedures. We investigated the completion rate and diagnostic yield of VCE carried out in outpatients with implantable cardiac devices.
  
  
  METHODS
  We carried out a retrospective review of all VCE from April 2010 through March 2013 at our center. Patients that underwent VCE through a specialized protocol for outpatients with implantable cardiac devices were identified. The protocol used telemetry for cardiac monitoring during battery lifespan of the VCE. Demographic data, procedure indications, results and any procedural events were collected.
  
  
  RESULTS
  Twenty-one patients met the study criteria, with 16 (76%) pacemakers, four (19%) implantable cardioverter defibrilla tors and one (5%) implantable hemodynamic monitor. Two (10%) devices were adjusted prior to VCE. Twenty (95%) were completed to the colon, with a median gastric transit time of 18 min and a small bowel transit time of 216 min. The procedure was diagnostic in 13 (62%) patients. One (5%) capsule retention event occurred. No cardiac events or video capture disturbances occurred.
  
  
  CONCLUSIONS
  Video capsule endoscopy done on outpatients with implantable cardiac devices through a cardiac monitoring protocol resulted in a satisfactory completion rate and high diagnostic yield with no adverse cardiac events. A large prospective trial is needed to confirm these novel results.
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, USA.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Stanich
authors.forename: Bryan
authors.initials: B
authors.lastname: Kleinman
authors.forename: Kavita
authors.initials: K
authors.lastname: Betkerur
authors.forename: Nishaki
authors.initials: N
authors.lastname: Mehta Oza
authors.forename: Kyle
authors.initials: K
authors.lastname: Porter
authors.forename: Marty M
authors.initials: MM
authors.lastname: Meyer
mesh_terms: D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D017147:Defibrillators, Implantable; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007421:Intestine, Small; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010045:Outpatients; D010138:Pacemaker, Artificial; D061214:Patient Safety; D012189:Retrospective Studies
keywords: completion rate; implantable cardiac defibrillator; implantable cardiac device; telemetry; video capsule endoscopy