Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices

Stanich, Peter P.; Kleinman, Bryan; Betkerur, Kavita; Oza, Nishaki Mehta; Porter, Kyle; Meyer, Marty M.

doi:10.1111/den.12288

Cited by 20 publications

(11 citation statements)

References 17 publications

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“…Dementia, gastroparesis, an esophageal stricture or swallowing disorders, those patients who are inoperable or refuse surgery, partial or intermittent small bowel obstruction, patients who have defibrillators or pacemakers and pregnant women [20,21].…”

Section: Small Bowel Capsule Endoscopymentioning

confidence: 99%

Diagnostics in Colorectal Surgery

Ferhatoğlu¹,

Kartal²

2018

Colorectal Cancer - Diagnosis, Screening and Management

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Section: Small Bowel Capsule Endoscopymentioning

confidence: 99%

Diagnostics in Colorectal Surgery

Ferhatoğlu¹,

Kartal²

2018

Colorectal Cancer - Diagnosis, Screening and Management

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“…Nevertheless, users of VCE estimated EMI between capsules and cardiac devices possibly being life-threatening for patients. Since the introduction of VCE, several in vitro and in vivo studies analyzed EMI between VCE (PillCam and EndoCapsule) and PMs ( in vitro :[42-44]; in vivo :[44-54]), implantable cardioverter defibrillators (ICD) ( in vitro :[55,56]; in vivo :[45-48,54,56-59]) and left ventricular assist devices (LVAD) ( in vitro : none, in vivo :[52,60-68]).…”

Section: Vce In Patients With Implantable Cardiac Devicesmentioning

confidence: 99%

“…This observation is in contrast to our results. We tested five Belos ICDs and found no interference by the capsules at all, even though the devices were investigated in the most sensitive setting[54]. Furthermore, there are several in vivo studies investigating interference between VCE and PMs and ICDs.…”

Section: Vce In Patients With Implantable Cardiac Devicesmentioning

confidence: 99%

“…Furthermore, there are several in vivo studies investigating interference between VCE and PMs and ICDs. Interrogation of the devices (in all or some patients) either before and/or after VCE was performed in some studies (PM:[44,46-48,52-54]; ICD:[48,52,54,57-59]) whereas (all or some) patients in other studies were monitored with ECG monitor, telemetry or clinically (PM:[44-54] ICD:[44-49,52,54,57-59]). No interference with any of the PMs or ICDs in in vivo studies was observed.…”

Section: Vce In Patients With Implantable Cardiac Devicesmentioning

confidence: 99%

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Contraindications for video capsule endoscopy

Bandorski¹,

Kurniawan²,

Baltes³

et al. 2016

WJG

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Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn’s disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication. Endoscopic placement of the capsule should be considered in patients with swallowing disorders to avoid aspiration. Esophageal or gastric motility disorders may require endoscopic capsule transport or application of prokinetics if the real-time viewer proofs delayed transit. In pregnant women, VCE should be restricted to urgent cases where diagnosis cannot be postponed after delivery, as data on safety are missing. There is theoretical and clinical evidence that patients with implanted cardiac devices such as a pacemaker, cardioverters or left heart assist devices, can safely undergo VCE in spite of still existing contraindication by manufacturers. Children from the age of 2 years have safely undergone VCE. Although video capsules are not proven safe with magnetic resonance imaging (MRI), first single cases of patients incidentally undergoing MRI with an incorporated capsule have been reported, showing susceptibility artifacts but no signs of clinical harm.

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“…Despite initial concerns, Capsule endoscopy also has not been found to interfere with these devices, nor does pacemaker affects imaging done with Capsule endoscopy [25,26] . Capsule endoscopy may be safely undertaken in patients with pacemakers and implanted defibrillators.…”

Section: Pearlmentioning

confidence: 99%

Myths, fallacies and practical pearls in GI lab

Kumar¹

2014

WJGE

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Many prevalent practices and guidelines related to Gastrointestinal endoscopy and procedural sedation are at odds with the widely available scientific-physiological and clinical outcome data. In many institutions, strict policy of pre-procedural extended fasting is still rigorously enforced, despite no evidence of increased incidence of aspiration after recent oral intake prior to sedation. Supplemental oxygen administration in the setting of GI procedural sedation has been increasingly adopted as reported in the medical journals, despite clear evidence that supplemental oxygen blunts the usefulness of pulse oximetry in timely detection of sedation induced hypoventilation, leading to increased number of adverse cardiopulmonary outcomes. Use of Propofol by Gastroenterologist-Nurse team is erroneously considered dangerous and often prohibited in various institutions, at the same time worldwide reports of remarkable safety and patient satisfaction continue to be published, dating back more than a decade. Of patient monitoring practices that have been advocated to be standard, many merely add cost, not value. Advances in the technology often are not incorporated in a timely manner in guidelines or clinical practices, e.g. , Capsule endoscopy or electrocautery during GI procedures do not interfere with proper functioning of the current pacemakers or defibrillators. Orthopedic surgeons have continued to recommend prophylactic antibiotics for joint replacement patients prior to GI procedures, without any evidence of need. These myths are explored for a succint review to prompt a change in clinical practices and institutional policies. Core tip: Many prevalent endoscopic procedural practices and policies are not only unsupported by clinical and scientific evidence, but are counterproductive. Rather than enhancing patient safety and comfort, these increase risk and expense, introduce unnecessary delays. Evidence to reach proper decisions about these topics has been available for a while, but is not appropriately acknowledged and implemented. Avoiding these pitfalls can have a significant positive impact because these policies cover routine events, actions and decisions, including: required prolonged pre-procedural fasting, routine supplemental oxygen during sedation, prohibition of Propofol use by nonanesthesia personnel, multiple monitoring practices and prophylactic recommendations.Kumar P. Myths, fallacies and practical pearls in GI lab. World J Gastrointest Endosc 2014; 6(12): 584-591 Available from: URL:

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Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices

Abstract: 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.

Cited by 20 publications

References 17 publications

Diagnostics in Colorectal Surgery

Diagnostics in Colorectal Surgery

Contraindications for video capsule endoscopy

Myths, fallacies and practical pearls in GI lab

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