Clin Endosc.  2016 Mar;49(2):176-181. 10.5946/ce.2015.023.

Endoscopic Electrosurgery in Patients with Cardiac Implantable Electronic Devices

• Baeg MK
• Kim SW
• Ko SH
• Lee YB
• Hwang S
• Lee BW
• Choi HJ
• Park JM
• Lee IS
• Oh YS
• Choi MG

• KMID: 2165042
• DOI: http://doi.org/10.5946/ce.2015.023

Abstract

BACKGROUND/AIMS
Patients with cardiac implantable electronic devices (CIEDs) undergoing endoscopic electrosurgery (EE) are at a risk of electromagnetic interference (EMI). We aimed to analyze the effects of EE in CIED patients.
METHODS
Patients with CIED who underwent EE procedures such as snare polypectomy, endoscopic submucosal dissection (ESD), and endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) were retrospectively analyzed. Postprocedural symptoms as well as demographic and outpatient follow-up data were reviewed through medical records. Electrical data, including preprocedural and postprocedural arrhythmia records, were reviewed through pacemaker interrogation, 24-hour Holter monitoring, or electrocardiogram.
RESULTS
Fifty-nine procedures in 49 patients were analyzed. Fifty procedures were performed in 43 patients with a pacemaker, and nine were performed in six patients with an implantable cardioverter-defibrillator. There were one gastric and 44 colon snare polypectomies, five gastric and one colon ESDs, and eight ERCPs with EST. Fifty-five cases of electrical follow-up were noted, with two postprocedural changes not caused by EE. Thirty-one pacemaker interrogations had procedure recordings, with two cases of asymptomatic tachycardia. All patients were asymptomatic with no adverse events.
CONCLUSIONS
Our study reports no adverse events from EE in patients with CIED, suggesting that this procedure is safe. However, because of the possibility of EMI, recommendations on EE should be followed.

Keyword

Endoscopic electrosurgery; Electromagnetic interference; Defibrillators, implantable; Permanent pacemaker

MeSH Terms

Arrhythmias, Cardiac
Cholangiopancreatography, Endoscopic Retrograde
Colon
Defibrillators, Implantable
Electrocardiography
Electrocardiography, Ambulatory
Electrosurgery*
Follow-Up Studies
Humans
Magnets
Medical Records
Outpatients
Retrospective Studies
SNARE Proteins
Sphincterotomy, Endoscopic
Tachycardia
SNARE Proteins

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