Department of Medicine, Division of Gastroenterology, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
Gastroenterol Res Pract. 2013;2013:959234. doi: 10.1155/2013/959234. Epub 2013 Apr 3.
Background and Study Aims. The presence of an implantable electromechanical cardiac device (IED) has long been considered a relative contraindication to the performance of video capsule endoscopy (CE). The primary aim of this study was to evaluate the safety of CE in patients with IEDs. A secondary purpose was to determine whether IEDs have any impact on images captured by CE. Patients and Methods. A retrospective chart review of all patients who had a capsule endoscopy at Mayo Clinic in Scottsdale, AZ, USA, or Rochester, MN, USA, (January 2002 to June 2010) was performed to identify CE studies done on patients with IEDs. One hundred and eighteen capsule studies performed in 108 patients with IEDs were identified and reviewed for demographic data, method of preparation, and study data. Results. The most common indications for CE were obscure gastrointestinal bleeding (77%), anemia (14%), abdominal pain (5%), celiac disease (2%), diarrhea (1%), and Crohn's disease (1%). Postprocedure assessments did not reveal any detectable alteration on the function of the IED. One patient with an ICD had a 25-minute loss of capsule imaging due to recorder defect. Two patients with LVADs had interference with capsule image acquisition. Conclusions. CE did not interfere with IED function, including PM, ICD, and/or LVAD and thus appears safe. Additionally, PM and ICD do not appear to interfere with image acquisition but LVAD may interfere with capsule images and require that capsule leads be positioned as far away as possible from the IED to assure reliable image acquisition.
背景与研究目的。长期以来,存在可植入电机械心脏装置(IED)被认为是行视频胶囊内镜(CE)的相对禁忌证。本研究的主要目的是评估有 IED 的患者行 CE 的安全性。次要目的是确定 IED 是否会对 CE 所获取的图像产生任何影响。
患者和方法。对 2002 年 1 月至 2010 年 6 月在美国亚利桑那州斯科茨代尔的梅奥诊所或明尼苏达州罗切斯特进行的所有有 IED 的患者的胶囊内镜检查的病历进行回顾性图表审查,以确定在有 IED 的患者中进行的 CE 研究。确定并回顾了 108 例有 IED 的患者的 118 例胶囊研究,以评估人口统计学数据、准备方法和研究数据。
结果。CE 的最常见适应证为不明原因的胃肠道出血(77%)、贫血(14%)、腹痛(5%)、乳糜泻(2%)、腹泻(1%)和克罗恩病(1%)。术后评估未发现 IED 功能有任何可察觉的改变。1 例 ICD 患者因记录器故障导致胶囊成像丢失 25 分钟。2 例 LVAD 患者的胶囊图像采集受到干扰。
结论。CE 未干扰 IED 功能,包括 PM、ICD 和/或 LVAD,因此似乎是安全的。此外,PM 和 ICD 似乎不会干扰图像采集,但 LVAD 可能会干扰胶囊图像,需要将胶囊导联尽可能远离 IED 放置,以确保可靠的图像采集。