Abstract 16376: Cardiovascular Stroke Nursing Best Abstract Award: Intra-Intestinal Energy Delivery During Endoscopy Does Not Affect Implanted Defibrillators
Introduction: Published guidelines recommend that an implantable cardioverter defibrillator (ICD) be deactivated during gastrointestinal endoscopy (GE) to prevent detection of energy and resulting spurious device discharge.
Hypothesis: We hypothesized that ICDs will not detect energy delivered during GE procedures.
Methods: Patients with an ICD about to undergo GE had their ICD reprogrammed to detect ventricular arrhythmias, record them in device memory, but not treat them. After the procedure, the ICD was interrogated to determine if any arrhythmia had been detected and then to reactivate the device.
Results: The study population consisted of 98 patients including 80 men (82%) and 18 (18%) women. The mean age was 70.3 ± 12.2 years. The patients underwent a total of 159 non-emergent GE procedures: 65 upper GI (including EGD and ERCP procedures) and 94 lower GI procedures (colonoscopy). Intra-intestinal energy potentially detectable by an ICD was delivered during 35 procedures (22 %). This included cautery to control bleeding and “hot-snare” forceps to remove polyps in 5 upper GE and 30 lower GE (including 14 polyps in the transverse colon). The ICDs detected no arrhythmia in any of the procedures.
Conclusions: As non-emergent upper and lower endoscopy procedures are presently performed, energy that might be potentially detected by ICD devices is used in a minority of procedures (22% in our series). Even when such energy is delivered in areas of the intestine that are closest to the ICD lead in the right ventricle, such as cautery during ERCP or “hot snare” forceps to remove transverse colon polyps, the ICD does not detect the energy as ventricular arrhythmia. Our observations support our hypothesis and suggest that ICDs do not need to be deactivated during gastrointestinal endoscopy procedures.
Author Disclosures: C. Wright: None. A. Markel: None. C.A. McPherson: None.
- © 2016 by American Heart Association, Inc.