[Two episodes of fatal ventricular arrhythmia associated with use of electrosurgical unit during redo MVR procedure]

We report a case of ventricular fibrillation in the first episode and ventricular tachycardia in the second episode that occurred with use of electrosurgical unit during redo MVR procedure. Both arrhythmia occurred five to ten seconds after application of the electrosurgical knife in the coagulation mode to the sternal periosteum. The patient was immediately resuscitated with return to sinus rhythm using direct-current electroshock. In the literature, it was reported that large direct-current potentials were generated during electrosurgery and that these potentials increased with increasing sparking at the active electrode. Care should be always taken because they may cause fatal ventricular arrhythmia.