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Published on: April 21, 2013
Electromagnetic Interference (EMI) and arrhythmic events in ICD patients undergoing gastrointestinal procedures
Danette Guertin1, Osman Faheem, Thea Ling
1Section of Heart Rhythm Management, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut 06102, USA.
Pacing and Clinical Electrophysiology : PACE
|June 6, 2007
Summary
Electromagnetic interference (EMI) from gastrointestinal endoscopy did not trigger arrhythmic events in patients with implantable cardioverter-defibrillators (ICDs). Routine deactivation of ICDs may not be necessary during these procedures.
Area of Science:
- Cardiology
- Gastroenterology
- Biomedical Engineering
Background:
- Implantable cardioverter-defibrillators (ICDs) manage sudden cardiac death risk.
- Electromagnetic interference (EMI) from medical procedures can affect ICD function.
- Electrocautery (EC) used in endoscopy may pose an EMI risk to ICDs.
Purpose of the Study:
- To evaluate the effect of EMI during gastrointestinal endoscopy on patients with ICDs.
- To assess the safety of endoscopic procedures with ICDs, with or without EC.
Main Methods:
- Prospective evaluation of 41 patients with ICDs undergoing 52 gastrointestinal endoscopic procedures.
- ICDs were programmed to 'detection-only' mode with therapies deactivated.
- Procedures included biopsies, coagulation, and polypectomy, with some utilizing unipolar EC.
Main Results:
- No EMI or tachyarrhythmic events were detected in any patient post-procedure.
- Eighteen procedures (43.9%) required interventions, 10 (55%) of which used EC.
- Unipolar EC with a mean current of 19.6 mA was used without adverse events.
Conclusions:
- Gastrointestinal endoscopy with or without EC appears safe for patients with transvenous ICDs.
- Current recommendations to deactivate ICDs before these procedures may be reconsidered.
- Larger studies are needed to confirm these findings and inform guideline changes.
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