Veitch A, Fairclough P
Digestive Diseases Research Centre, St Bartholomew's and the Royal London School of Medicine and Dentistry, UK.
Endoscopy. 1998 Aug;30(6):544-7. doi: 10.1055/s-2007-1001341.
Malfunction of cardiac pacemakers related to diathermy in surgical procedures has been reported, but the risks of endoscopic diathermy in pacemaker patients is unknown. The aim of this study was to investigate current practice amongst British gastroenterologists regarding endoscopy in cardiac pacemaker patients.
An anonymous postal questionnaire survey of 634 members of the Endoscopy section of the British Society of Gastroenterology was conducted.
410/634 (65%) replied. Respondents conducted 59270 endoscopic retrograde cholangiopancreatography procedures (ERCPs) and 88544 colonoscopies per year. 77.3% of respondents were aware of the possibility of adverse interactions between diathermy and pacemakers. 74.2% enquired whether a pacemaker was present prior to endoscopy. In cases where patients were known to have pacemakers fitted, 23.9% recorded an electrocardiogram (ECG) prior to endoscopic diathermy, 36.2% conducted ECG monitoring during the procedure, 35.9% consulted a cardiologist or pacemaker technician and 13.4% carried out specific preventative measures. 4.1% of all respondents were aware of instances of pacemaker malfunction having occurred during endoscopic diathermy.
Most gastroenterologists surveyed were aware of the possibility of adverse interactions between diathermy and cardiac pacemakers, but few undertook measures to detect or prevent pacemaker malfunction. Endoscopic diathermy in cardiac pacemaker patients, however, appears generally safe, although the endoscopist should be aware of the small chance of an adverse interaction.
已有报道称手术过程中与透热疗法相关的心脏起搏器功能故障，但心脏起搏器患者接受内镜透热疗法的风险尚不清楚。本研究的目的是调查英国胃肠病学家针对心脏起搏器患者进行内镜检查的当前做法。
对英国胃肠病学会内镜科的634名成员进行了匿名邮寄问卷调查。
634名受访者中有410名（65%）回复。受访者每年进行59270例内镜逆行胰胆管造影术（ERCP）和88544例结肠镜检查。77.3%的受访者意识到透热疗法与起搏器之间可能存在不良相互作用。74.2%的受访者在内镜检查前询问患者是否装有起搏器。在已知患者装有起搏器的情况下，23.9%的受访者在内镜透热疗法前记录心电图（ECG），36.2%的受访者在手术过程中进行ECG监测，35.9%的受访者咨询心脏病专家或起搏器技术人员，13.4%的受访者采取了特定的预防措施。4.1%的受访者知晓在内镜透热疗法期间发生起搏器故障的情况。
大多数接受调查的胃肠病学家意识到透热疗法与心脏起搏器之间可能存在不良相互作用，但很少采取措施检测或预防起搏器故障。然而，心脏起搏器患者的内镜透热疗法总体上似乎是安全的，尽管内镜医师应意识到发生不良相互作用的可能性较小。
