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.