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KMID : 1038120160490020176
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Clinical Endoscopy
2016 Volume.49 No. 2 p.176 ~ p.181
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Endoscopic Electrosurgery in Patients with Cardiac Implantable Electronic Devices
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Baeg Myong-Ki
Kim Sang-Woo
Ko Sun-Hye
Lee Yoon-Bum
Hwang Sea-Won
Lee Bong-Woo
Choi Hye-Jin
Park Jae-Myung
Lee In-Seok
Oh Yong-Seog
Choi Myung-Gyu
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Abstract
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Background/Aims: Patients with cardiac implantable electronic devices (CIEDs) undergoing endoscopic electrosurgery (EE) are at a risk of electromagnetic interference (EMI). We aimed to analyze the effects of EE in CIED patients.
Methods: Patients with CIED who underwent EE procedures such as snare polypectomy, endoscopic submucosal dissection (ESD), and endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) were retrospectively analyzed. Postprocedural symptoms as well as demographic and outpatient follow-up data were reviewed through medical records. Electrical data, including preprocedural and postprocedural arrhythmia records, were reviewed through pacemaker interrogation, 24-hour Holter monitoring, or electrocardiogram.
Results: Fifty-nine procedures in 49 patients were analyzed. Fifty procedures were performed in 43 patients with a pacemaker, and nine were performed in six patients with an implantable cardioverter-defibrillator. There were one gastric and 44 colon snare polypectomies, five gastric and one colon ESDs, and eight ERCPs with EST. Fifty-five cases of electrical follow-up were noted, with two postprocedural changes not caused by EE. Thirty-one pacemaker interrogations had procedure recordings, with two cases of asymptomatic tachycardia. All patients were asymptomatic with no adverse events.
Conclusions: Our study reports no adverse events from EE in patients with CIED, suggesting that this procedure is safe. However, because of the possibility of EMI, recommendations on EE should be followed.
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KEYWORD
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Endoscopic electrosurgery, Electromagnetic interference, Defibrillators, implantable, Permanent pace
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