Intraoperative pacemaker dysfunction caused by the use of electrocautery during a total hip arthroplasty
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Published on: September 24, 2021
O A Nercessian1, H Wu, D Nazarian
1Department of Orthopaedic Surgery, New York Orthopaedic Hospital, Columbia University College of Physicians and Surgeons, New York, USA.
Insights
Pacemaker dysfunction is a rare risk during orthopedic surgery. Electrocautery use can lead to pacemaker failure, as seen in a total hip replacement case.
Area of Science:
- Orthopedic Surgery
- Cardiovascular Implants
Background:
- Orthopedic procedures are increasingly common in aging populations, many of whom have pacemakers.
- Electrocautery is standard for hemostasis in major orthopedic surgeries.
- Pacemaker dysfunction during these procedures is a rare but serious complication.
Observation:
- A patient undergoing total hip replacement experienced pacemaker failure.
- This failure occurred after a single use of unipolar electrocautery.
Findings:
- Electrocautery, particularly unipolar, poses a risk of pacemaker malfunction.
- This case highlights a specific instance of pacemaker failure linked to electrocautery.
Implications:
- Orthopedic surgeons must be aware of the risks associated with electrocautery in pacemaker patients.
- Careful consideration and potential alternative hemostasis methods may be needed.
- Further research into safe electrocautery use in pacemaker patients is warranted.
Abstract:
Pacemaker dysfunction encountered during orthopedic procedures is a rare but potentially life-threatening complication. With an increasing number of orthopedic procedures performed on the aging population, it is not uncommon to encounter patients with pacemakers requiring major orthopedic intervention. Most, if not all, major orthopedic procedures performed today require the use of electrocautery for hemostasis. In this article we review the literature for pacemaker complications and report a case of pacemaker failure after a single use of the unipolar electrocautery on a patient undergoing a total hip replacement.