Reducing Risk During Endoscopy in Patients with Implanted Electronic Devices

The implantation of electronic devices to monitor and alter cardiac or neurologic function or to deliver pharmaceuticals is becoming commonplace. Gastrointestinal endoscopists should be attentive to the presence of implanted electronic devices and aware of the basic means for limiting risk during the use of electrocautery in patients who have such devices in place. The risk is relatively limited in most patients, and precautions for reducing risk are easily employed. Generic and specific recommendations are discussed pertinent to use of electrocautery in patients with cardiac and neurologic devices. Selected pacemaker-dependent patients with implanted intracardiac defibrillators and those with implanted deep brain stimulators or gastric pacing devices warrant specific specialty comment before endoscopy. Additional data are needed regarding the general safety of endoscopic electrocautery and the recommended precautions in these patients.