ENDOSCOPIC DIATHERMY IN PATIENTS WITH CARDIAC-PACEMAKERS

Background and Study Aims: Malfunction of cardiac pacemakers related t o diathermy in surgical procedures has been reported, but the risks of endoscopic diathermy in pacemaker patients is unknown. The aim of thi s study mas to investigate current practice amongst British gastroente rologists regarding endoscopy in cardiac pacemaker patients. Methods: An anonymous postal questionnaire survey of 634 members of the Endosco py section of the British Society of Gastroenterology was conducted. R esults: 410/634 (65%) replied. Respondents conducted 59270 endoscopic retrograde cholangiopancreatography procedures (ERCPs) and 88544 colon oscopies per year. 77.3 % of respondents were aware of the possibility of adverse interactions between diathermy and pacemakers. 74.2% enqui red whether a pacemaker was present prior to endoscopy, In cases where patients were known to have pacemakers fitted, 23.9% recorded an elec trocardiogram (ECG) prior to endoscopic diathermy, 36.2% conducted ECG monitoring during the procedure, 35.9% consulted a cardiologist or pa cemaker technician and 13.4% carried out specific preventative measure s. 4.1% of all respondents were aware of instances of pacemaker malfun ction having occurred during endoscopic diathermy. Conclusion: Most ga stroenterologists surveyed were aware of the possibility of adverse in teractions between diathermy and cardiac pacemakers, but few undertook measures to detect or prevent pacemaker malfunction, Endoscopic diath ermy in cardiac pacemaker patients, how-ever, appears generally safe, although the endoscopist should be aware of the small chance of an adv erse interaction.