Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, USA.
Dig Endosc. 2014 Nov;26(6):726-30. doi: 10.1111/den.12288. Epub 2014 Mar 27.
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.
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.
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.
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.
由于担心干扰，植入式心脏设备是视频胶囊内镜（VCE）的相对禁忌证。由于缺乏替代方法，一些中心已采用方案允许这些患者进行 VCE。关于这些程序的胃肠道结果，发表的描述很少。我们调查了在植入式心脏设备的门诊患者中进行 VCE 的完成率和诊断效果。
我们对 2010 年 4 月至 2013 年 3 月期间在我们中心进行的所有 VCE 进行了回顾性分析。确定了通过专门针对植入式心脏设备门诊患者的方案进行 VCE 的患者。该方案在 VCE 电池寿命期间使用遥测进行心脏监测。收集了人口统计学数据、程序适应证、结果和任何程序事件。
21 名患者符合研究标准，其中 16 名（76%）为起搏器，4 名（19%）为植入式心律转复除颤器，1 名（5%）为植入式血流动力学监测器。在进行 VCE 之前调整了 2 个（10%）设备。20 个（95%）完成到结肠，胃传输时间中位数为 18 分钟，小肠传输时间为 216 分钟。该程序在 13 名（62%）患者中具有诊断意义。发生了 1 例（5%）胶囊滞留事件。没有发生心脏事件或视频捕获干扰。
通过心脏监测方案对植入式心脏设备的门诊患者进行 VCE，结果令人满意，完成率高，诊断效果好，且无不良心脏事件。需要进行大型前瞻性试验来证实这些新结果。
