Do endoscopy capsules interfere with implantable cardioverter-defibrillators?

Background and study aims: Capsule endoscopy is already an established diagnostic tool, and the newly introduced capsule PillCam COLON is now entering clinical studies. Because of the very limited clinical experience in patients with implantable cardioverter-defibrillators (ICDs), it is generally recommended that capsule endoscopy should not be used in these patients. Therefore, we investigated, in vitro, the possible interference between three different endoscopy capsules (Given Imaging and Olympus) and ICDs.

Materials and methods: A total of 45 ICD devices were separately placed in a tank filled with a 0.9 % saline solution. With the help of pin jacks, the pacing pulses of ICDs were recorded and inhibiting signals could be coupled in. The capsules were placed in different positions near to the lead and the ICD device, and finally placed on the case of the device for 1 minute each. The function of each device was observed continuously.

Results: Even when the capsules were in closest proximity to the ICDs, no interference was observed.

Conclusion: The clinical use of the three tested capsule devices is safe in patients with ICDs.

References

• 1 Ell C, Remke S, May A. et al . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.  Endoscopy. 2002;  34 685-689
• 2 Lewis B S, Swain P. Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding. Results of a pilot study.  Gastrointest Endosc. 2002;  56 349-353
• 3 Neu B, Ell C, May A. et al . Capsule endoscopy versus standard testing influencing management of obscure digestive bleeding: results from a German multicenter trial.  Am J Gastroenterol. 2005;  100 1736-1742
• 4 Eliakim R, Fireman Z, Gralnek I M. et al . Evaluation of the PillCam COLON Capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study.  Endoscopy. 2006;  38 963-970
• 5 Schoofs N, Deviére J, van Gossum A. PillCam COLON Capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot study.  Endoscopy. 2006;  38 971-977
• 6 Dubner S, Dubner Y, Rubio H, Goldin E. Electromagnetic interference from wireless video-capsule endoscopy on implantable cardioverter-defibrillators.  Pacing Clin Electrophysiol. 2007;  30 472-475
• 7 Bandorski D, Irnich W, Brück M. et al . Capsule endoscopy and cardiac pacemakers: investigation for possible interference.  Endoscopy. 2008;  40 36-39
• 8 Irnich W. Störbeeinflussung von implantierten Schrittmachern und Defibrillatoren.  Herzschr Elektrophys. 2004;  15 9-21
• 9 Irnich W, Batz L, Müller R, Tobisch R. Electromagnetic interference of pacemakers by mobile phones.  Pacing Clin Electrophysiol. 1996;  19 1431-1446
• 10 CEN/CENELEC (Commission Européenne de Normalisation/Commission Européenne de Normalisation Electrotechnique et Electronique) .EN 45502-2-1: 2004 Active implantable medical devices Part 2-1: Particular requirements for active implantable medical devices intended to treat bradyarrhythmia (cardiac pacemakers). Central Secretariat: rue de Stassart 35, B – 1050 Brussels
• 11 Leighton J A, Srivathsan K, Carey E J. et al . Safety of wirless capsule endoscopy in patients with implantable cardiac defibrillators.  Am J Gastroenterol. 2005;  100 1728-1731
• 12 Pelargonio G, Dello Russo A, Pace M. et al . Use of video capsule endoscopy in a patient with an implantable cardiac defibrillator.  Europace. 2006;  8 1062-1063
• 13 Bandorski D, Diehl K L, Jaspersen D. Kapselendoskopie bei Herzschrittmacher-Patienten: aktueller Stand in Deutschland.  Z Gastroenterol. 2005;  43 715-718
• 14 Barbaro V, Bartolini P, Donato A, Militello C. Eletromagnetic interference of pacemakers by mobile phones.  Pacing Clin Electrophysiol. 1996;  19 1410-1418
• 15 Dubner S, Dubner Y, Gallino S. et al . Electromagnetic interference with implantable cardiac pacemakers by video capsule.  Gastrointest Endosc. 2005;  61 250-254