Key result
Colonoscopy and bowel preparation linked to ~10% increase in ventricular arrhythmia marker iCEB.
Why the study?
Electrolyte disturbances and autonomic dysfunction from bowel preparation and colonoscopy may contribute to cardiac arrhythmias, prompting assessment of whether the index of cardiac-electrophysiological balance (iCEB) predicts procedure-related ventricular arrhythmia risk.
Does elective colonoscopy with bowel preparation alter the index of cardiac-electrophysiological balance (iCEB) in adult patients?
Observational (n=36)
No
Does elective colonoscopy with bowel preparation alter the index of cardiac-electrophysiological balance (iCEB) in adult patients?
Elective colonoscopy and bowel preparation significantly increase the index of cardiac-electrophysiological balance (iCEB) and QT interval, suggesting a potential non-invasive marker for identifying patients at increased risk of post-procedural ventricular arrhythmias.
Answers are grounded in this paper and cite their sources.
May signal transient post-colonoscopy arrhythmia vulnerability; hypothesis-generating and should not yet change practice.
Background and Objectives: Colorectal cancer is the second leading cause of cancer-related deaths in the U.S., and colonoscopy is a critical tool for colon cancer screening and diagnosis. Electrolyte disturbances and autonomic nervous system dysfunction that may occur due to bowel preparation and the colonoscopy procedure itself may play a role in the development of cardiac arrhythmia. This study aimed to assess the index of cardiac–electrophysiological balance (iCEB) to predict ventricular arrhythmia risk related to colonoscopy. Materials and Methods: Patients undergoing elective colonoscopy with a normal sinus rhythm were included. Electrocardiography (ECG) recordings both before bowel preparation and after the colonoscopy procedure were obtained. Values of the index of cardiac–electrophysiological balance (iCEB) were compared. Results: Among 36 patients, it was determined that the heart rate values of the patients before bowel preparation were higher than the heart rate values after colonoscopy [74.5 (60–108) bpm vs. 68.5 (53–108) bpm, p = 0.021]. The duration of QT interval increased (370.9 ± 27.8 ms vs. 398.7 ± 29.4 ms, p < 0.001) and the iCEB increased from 4.1 ± 0.5 to 4.5 ± 0.6 (p < 0.001), indicating a significant post-procedural risk of ventricular arrhythmias. Conclusions: These findings suggest that routine iCEB assessment post-colonoscopy could identify high-risk patients requiring closer monitoring.
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Polatkan et al. (2024) conducted an observational in Elective colonoscopy (n=36). Colonoscopy and bowel preparation vs. Pre-bowel preparation baseline was evaluated on Index of cardiac-electrophysiological balance (iCEB) (p=<0.001). Colonoscopy and bowel preparation significantly increased the index of cardiac-electrophysiological balance from 4.1 to 4.5 (p < 0.001), indicating an elevated post-procedural risk of ventricular arrhythmias.
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