Case report: use caution when applying magnets to pacemakers or defibrillators for surgery

Area of Science:

• Cardiology
• Biomedical Engineering
• Anesthesiology

Background:

• Magnets are sometimes used during surgery with cardiac implanted electronic devices (CIEDs) like pacemakers and implanted cardioverter defibrillators (ICDs).
• The intended effects, such as asynchronous pacing or shock prevention, may not always occur as expected.
• Lack of understanding regarding magnet application can lead to adverse events.

Observation:

• Presents 3 cases where magnet application to CIEDs during surgery resulted in negative outcomes.
• Inadequate assessment of CIED function and programming was a contributing factor.
• Observed consequences included inappropriate antitachycardia pacing, shocks, device damage, and patient injury.

Findings:

• Magnet application without proper understanding can cause unexpected CIED behavior.
• Inappropriate antitachycardia pacing or shocks may occur.
• Patient injury and CIED damage are potential risks.

Implications:

• Highlights the critical need for detailed preoperative CIED assessment and programming review.
• Reinforces recommendations from the American Society of Anesthesiologists and the Heart Rhythm Society.
• Emphasizes the importance of understanding magnet effects on CIEDs to ensure patient safety during procedures.