Capsule endoscopy in patients with cardiac pacemakers, implantable cardioverter defibrillators and left heart assist devices.
According to the recommendations of the US Food and Drug Administration and manufacturers, capsule endoscopy should not be used in patients carrying implanted cardiac devices. For this review we considered studies indexed (until 30.06.2013) in Medline [keywords: capsule endoscopy, small bowel endoscopy, cardiac pacemaker, implantable cardioverter defibrillator, interference, left heart assist device], technical information from Given Imaging and one own publication (not listed in Medline). Severalin vitroandin vivostudies included patients with implanted cardiac devices who underwent capsule endoscopy. No clinically relevant interference was noticed. Initial reports on interference with a simulating device were not reproduced. Furthermore technical data of PillCam (Given Imaging) demonstrate that the maximum transmission power is below the permitted limits for cardiac devices. Hence, impairment of cardiac pacemaker, defibrillator or left ventricular heart assist device function by capsule endoscopy is not expected. However, wireless telemetry can cause dysfunction of capsule endoscopy recording. Application of capsule endoscopy is feasible and safe in patients with implanted cardiac devices such as pacemakers, cardioverter defibrillators, and left heart assist devices. Development of new technologies warrants future re-evaluation.
Medical Clinic II, University Hospital Giessen and Marburg GmbH, Giessen (Dirk Bandorski).
Dirk
D
Bandorski
Medical Clinic III, St. Agnes Hospital Bocholt (Reinhard Höltgen).
Reinhard
R
Höltgen
Research Center for Bioelectromagnetic Interaction (femu) Institute of Occupational and Social Medicine, University Hospital Aachen (Dominik Stunder).
Dominik
D
Stunder
Clinic for Internal Medicine, Bethesda Hospital Bergedorf (Martin Keuchel), Germany.
Martin
M
Keuchel
Capsule endoscopy; cardiac pacemakers; implantable cardioverter defibrillator; interference; left heart assist device