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Related Experiment Videos

Electrocautery-induced pacemaker malfunction during surgery.

D Mangar1, G M Atlas, P B Kane

  • 1Department of Anesthesiology, University of South Florida College of Medicine, Tampa 33612-4799.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|July 1, 1991
PubMed
Summary

Electrosurgery can cause pacemaker failure, even in asynchronous mode. A teenage girl experienced asystole due to pacemaker malfunction during cardiac surgery preparation.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Safety

Background:

  • Pacemakers are crucial for managing cardiac arrhythmias.
  • Surgical procedures often require electrocautery, a common source of electromagnetic interference.
  • Pacemaker settings are sometimes adjusted to asynchronous mode before surgery to prevent interference.

Observation:

  • A 15-year-old female patient experienced pacemaker failure leading to asystole.
  • The event occurred despite the pacemaker being set to asynchronous mode prior to cardiac surgery.
  • Unipolar electrocautery was used during the surgical preparation.

Findings:

  • Electromagnetic interference from unipolar electrocautery reduced pacemaker battery voltage.
  • This voltage reduction allowed digital circuitry to function but impaired the voltage control oscillator (VCO).

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  • Sustained battery current drain led to VCO lock-out, resulting in complete pacemaker and battery failure.

    • Implications:

    • Electrocautery poses a significant risk of pacemaker failure, irrespective of asynchronous mode conversion.
    • This case highlights the need for heightened awareness and potentially revised protocols for managing pacemakers during procedures involving electrocautery.
    • Further research is warranted to understand the precise mechanisms and develop mitigation strategies for electrocautery-induced pacemaker malfunction.