Electrosurgery in patients with implantable electronic cardiac devices (pacemakers and defibrillators)

The electrosurgical unit is a very useful tool widely used in dermatology to treat benign and malignant skin lesions and to achieve hemostasis during surgery. However, precautions are required when this technique is used in patients with implantable electronic cardiac devices (IECD), such as pacemakers and defibrillators, because electromagnetic interference produced by the tool may cause such devices to malfunction. Before using electrosurgery in patients with IECDs, it is essential to ascertain the type of implanted device and the patient's level of dependence on it. The location of the skin lesion to be treated with respect to the device should also be assessed. Bipolar pacemakers are more resistant to interference. Appropriate monitoring and the use of bipolar forceps are recommended.