Patients with Pacemakers or Metal Implants

Pacemakers. Prior to examination, it must be known whether the patient has a pacemaker or acute pacemaker dependence. Especially if a high frequency electrical current is going to be used (e.g., for polypectomy), the pacemaker type must be known and it must have been checked no more than three months prior to examination. If a high frequency current is going to be used, ECG monitoring during colonoscopy is mandatory and the pacemaker must also be checked on the same day after intervention. When applying the neutral electrode, the distance between the pacemaker cover and the active electrode (= localization of the endoscope tip) must be > 15 cm and the distance between the active and neutral electrodes must be smaller than that between the pacemaker and the active electrode. Implanted defibrillators (ICD) must be deactivated while using a high frequency current and reactivated afterward (using a ring magnet). Otherwise, there is danger that the antitachycar-dia function could misinterpret the high frequency impulses and respond with inadequate shock. When inactivated, there is no protection against malignant arrhythmias; the examiner must be prepared to perform defibrillation.

Metal implants. The examiner must also be aware of the presence of any metal implants when applying the neutral electrode. Again, the distance between the neutral electrode and the active electrode (= location of the endoscope tip or poly-pectomy) must be smaller than that between the active electrode and any metal implant. Artificial hip joints are particularly relevant for colonoscopy.

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Constipation Prescription

Constipation Prescription

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