Obtaining rapid and effective hemostasis: Part II. Electrosurgery in patients with implantable cardiac devices

Electrosurgery is an integral part of dermatology that is commonly used both to obtain hemostasis and to treat cutaneous lesions. However, it can cause many complications in patients with implantable devices. Because of the risk of electromagnetic interference, a variety of precautions are commonly used. Not only are there no consistent community-based standards in place regarding the performance of electrosurgery in patients with implantable devices, but these precautions are largely based upon anecdotal experience or recommendations from different specialties. To further complicate matters, the literature regarding electrosurgery use in patients with implantable cardiac devices is limited, especially with respect to dermatologic surgery. As the use of implantable cardiac devices continues to grow, our ability to care for patients with implantable devices must expand. Part II of this continuing medical education article discusses the current recommendations for using electrosurgery in patients with implantable cardiac devices during dermatologic procedures.