Endoscopic polypectomy for pacemaker patients: is it safe?

Background: Endoscopic polypectomy is believed to reduce the incidence of colorectal cancer, and it has become a standard practice for the removal of gastrointestinal polyps. However, for patients with implanted cardiac devices, endoscopic polypectomy is thought to be relatively contraindicated. Aside from two case reports from around 10 years ago, few studies have evaluated the safety of endoscopic polypectomy for this population. In this study, polypectomy was performed in 14 consecutive pacemaker patients to determine the safety of endoscopic polypectomy using high-frequency current in patients with implanted cardiac devices.

Methods: Fourteen patients with gastrointestinal polyps and implanted cardiac devices were evaluated, and endoscopic polypectomy was performed. Continuous monitoring of heart rate, blood pressure, oxygen saturation and electrocardiographic tracing was conducted. A trained cardiologist was present during the procedures. At the end of the procedures, the cardiac devices were reinterrogated to check for any changes.

Results: Our results showed that a total of 61 procedures in 14 patients were all successfully completed, and no abnormalities were identified during continuous monitoring. There were no statistically significant differences in the preoperation, intraoperation and postoperation data. None of the patients suffered any arrhythmias or functional disruption to their cardiac devices.

Conclusions: Endoscopic polypectomy using high-frequency current appears to be safe when performed in patients with pacemakers. However, larger multicentre studies are needed to confirm the safety of this procedure in this patient population.