ELECTROCARDIOGRAPHIC CHANGES IN ELDERLY PATIENTS DURING SMALL-BOWEL ENEMA

RATIONALE AND OBJECTIVES. Enteroclysis (small bowel enema) involves th e introduction of a large amount of fluid into the small bowel, throug h a tube, producing small bowel distention. A study was done to determ ine the incidence of any electrocardiographic changes during enterocly sis with Holter monitoring. METHODS. Continuous electrocardiographic m onitoring and 12-lead electrocardiograms were performed in 30 elderly patients undergoing enteroclysis and in 30 control subjects undergoing routine chest, bone, and upper gastrointestinal small bowel follow-up studies. Two channel qualitative and quantitative electrocardiographi c analysis was performed by a computerized nontriggered template syste m, Arrhythmias, change in cardiac axis, conduction defects, pauses, ST segment changes, and ectopics were sought. RESULTS. Increased sympath etic tone resulting in increased heart rate and transient atrial and v entricular ectopics was frequent during enteroclysis compared with the control group, In one patient ventricular tachycardia developed, and two patients had diminished heart rate, but this was attributed to pre existing heart disease and concurrent medication. CONCLUSIONS. Transie nt, nonhazardous cardiac arrythmias are encountered during enteroclysi s in elderly patients, These arrhythmias may be attributed to the pree xisting heart disease, fear, and anxiety during intubation, or increas ed sympathetic tone from the enteric loop distention.