Leighton Jonathan A, Sharma Virender K, Srivathsan Komandoor, Heigh Russell I, McWane Tony L, Post Janice K, Robinson Sara R, Bazzell Jane L, Fleischer David E
Current affiliations: Division of Gastroenterology and Hepatology and Division of Cardiology, Mayo Clinic Arizona, Scottsdale, Arizona 85259, USA.
Gastrointest Endosc. 2004 Apr;59(4):567-9. doi: 10.1016/s0016-5107(03)02879-7.
Capsule endoscopy, a new technology, allows visualization of the entire small intestinal mucosa. The main indication for capsule endoscopy at present is the evaluation of GI bleeding of obscure origin. Studies to date suggest that capsule endoscopy is safe and is associated with few adverse events. One concern, which has not been studied, is the potential effect of the capsule on cardiac pacemakers and other electromedical devices. The primary aims of this study were to evaluate the safety of capsule endoscopy in patients with cardiac pacemakers who are being evaluated for GI bleeding of obscure origin and to determine whether pacemakers have any effect on the images captured by the capsule endoscope.
Patients with cardiac pacemakers referred for evaluation of GI bleeding of obscure origin were entered into the study. Before the procedure, an electrocardiogram was obtained, and pacemaker functions were checked. Capsule endoscopy was performed in a hospital setting to allow closer monitoring, instead of the outpatient clinic, which is our routine. Cardiac rhythm was assessed simultaneously during capsule endoscopy with a Holter monitor. Post-procedure pacemaker function was again checked for any disturbance. When the capsule endoscopy studies were reviewed, observations were made with particular reference to technical difficulty or interference with imaging.
Five consecutive patients (4 men, 1 woman; mean age, 73 years, range 56-92 years) with cardiac pacemakers were studied. In all patients, the indication for capsule endoscopy was GI bleeding of obscure origin. A cardiologist and pacemaker nurse specialist reviewed the Holter monitor recordings and evaluated pacemaker function after the procedure for each patient. No arrhythmia or other adverse cardiac event was noted during capsule transmission. No pacemaker-induced interference on the capsule endoscopy images was observed.
Capsule endoscopy appears to be safe in patients with cardiac pacemakers and does not appear to be associated with any significant adverse cardiac event. Pacemakers do not interfere with capsule imaging.
胶囊内镜是一项新技术，可对整个小肠黏膜进行可视化检查。目前胶囊内镜的主要适应证是评估不明原因的胃肠道出血。迄今为止的研究表明，胶囊内镜是安全的，且不良事件较少。一个尚未得到研究的问题是胶囊对心脏起搏器和其他电子医疗设备的潜在影响。本研究的主要目的是评估胶囊内镜在因不明原因胃肠道出血而接受评估的心脏起搏器患者中的安全性，并确定起搏器对胶囊内镜所捕获图像是否有任何影响。
因不明原因胃肠道出血而转诊来接受评估的心脏起搏器患者纳入本研究。在检查前，获取心电图并检查起搏器功能。胶囊内镜检查在医院环境中进行以便更密切监测，而非在我们常规的门诊进行。在胶囊内镜检查期间，同时使用动态心电图监测仪评估心律。检查后再次检查起搏器功能有无任何干扰。在回顾胶囊内镜检查研究时，特别留意技术难度或对成像的干扰情况。
对5例连续的有心脏起搏器的患者（4例男性，1例女性；平均年龄73岁，范围56 - 92岁）进行了研究。所有患者中，胶囊内镜检查的适应证均为不明原因的胃肠道出血。一名心脏病专家和起搏器护士专家在检查后查看了每位患者的动态心电图监测记录并评估了起搏器功能。在胶囊传输过程中未发现心律失常或其他不良心脏事件。未观察到起搏器对胶囊内镜图像产生干扰。
对于有心脏起搏器的患者，胶囊内镜似乎是安全的，且似乎未伴有任何显著的不良心脏事件。起搏器不会干扰胶囊成像。
