5 YEAR EXPERIENCE- SAFETY/EFFICACY OF MIROCAM CAPSULE ENDOSCOPY IN PATIENTS WITH CARDIAC IMPLANTABLE ELECTRONIC DEVICES

Introduction Cardiac Implantable electronic devices (CIEDs) are seen to be a relative contraindication to capsule endoscopy (CE), due to concern that interaction between the 2 devices may lead to technical failure or interference to each device. Consequently, CE is performed infrequently in this cohort and hence significant pathology may be missed. The MiroCam capsule (Intromedic, Seoul) does not use the standard radiofrequency transmission, but a mechanism known as human body communication (HBC), considered to be safer. Our aim was to assess the safety and efficacy of CE in this cohort. Methods A retrospective analysis of a prospectively collected database of CE procedures between May 2014 and January 2019. All CIEDs were remotely checked on the day or by interrogation of log files post procedure for any technical disruption. All video footage from the CE was analysed to check for image degradation or signs of interference. The positive findings (PY), and those deemed to be diagnostic (DY) on capsule endoscopy were documented. Results 1018 CE procedures were performed during the study period. 45 of these were performed in patients with CIEDs (28 pacemakers, 6 implantable cardiac monitors, 5 defibrillators, 2 Cardiac Resynchronisation Therapy Pacemakers (CRT-P) and 4 CRT Defibrillators (CRT-D). The median age was 68 years with 62% females. The main indications were occult (n=21) and overt GI bleeding (n=15). Log files from all the implantable devices showed no signs of technical disruption. Video footage from CE showed no image degradation apart from one case which coincided with the use of a Microwave oven. The PY was 36/45= 80% v 332/641= 65.9% (p Conclusions CE with the MiroCam capsule has been shown to be safe within this large cohort of patients, with no incidences of any technical disruptions in patients with CIEDs. Considering the higher rate of positive and diagnostic findings in CIED patients, CE with the MiroCam capsule in patients with an CIEDs should not be considered a contraindication. Further studies are required to see if this translates to other capsule manufacturers.