Is Wireless Capsule Endoscopy Safe in Patients With Implantable Cardiac Devices?

Abstract

Introduction: Capsule endoscopy (CE) is widely used for the evaluation of small bowel pathology. Electromagnetic waves generated by CE may interfere with other electronic devices. For this reason, CE is contraindicated in patients with implantable cardiac devices. The primary aim of this study was to assess the safety of CE in patients with implantable cardiac devices. Methods: All patients who underwent CE and also had an implantable cardiac device such as pacemaker (PM), implantable cardiac defibrillators (ICD), and/or left ventricular assist device (LVAD) at an academic medical center from January 2007 to May 2014 were retrospectively reviewed. Age, gender, ethnicity, indication for CE, type of cardiac device(s) were evaluated. All patients underwent cardiac telemetry monitoring during CE. Pre and post procedure cardiac assessments were performed. Any cardiac events during CE and cardiac events within 30 days of study completion were reviewed. Results: Seventy-nine CE were performed on 70 patients who fulfilled inclusion criteria. The majority of patients were male (70.9%). Mean age was 67.9. Most patients were Caucasian (60.8%), followed by African American (25.3%), Hispanic (8.9%), Middle Eastern (3.8%), and Asian (1.3%). Patients most commonly had PM (46.8%), followed by PM + ICD (21.5%), ICD (13.9%), LVAD + ICD (12.7%), LVAD, ICD + PM (5.0%). Indications for CE included anemia (55.7%), GI bleed (26.6%), melena (8.8%), abdominal pain (6.3%) planned anticoagulation (1.3%), and Crohn’s disease (1.3%). During the study period of 8 hours, no cardiac events were noted on telemetry monitoring. No cardiac events occurred within 30 days of completion of CE. Recording of the CE images was not affected by the presence of cardiac devices. One patient experienced chest pain during the study, however, interrogation of the ICD revealed no cardiac event. Conclusion: Although CE is contraindicated in patients with implantable cardiac devices, our study demonstrates that CE may be safe in such patients. CE images were not compromised by the presence of cardiac devices.Table 1