Dertnatologic Electrosurgery in Patients with Implantable Cardioverter-Defibrillators and Pacemakers

Abstract

Knowledge of the potential electrosurgical interference with ICDs and pacemakers is required to perform these procedures safely. A perioperative management plan is suggested.

Electrocoagulation and hazardous damage to a dental prosthesis

“…The most common adverse events seen with ECDs are attributed to electrical interference of pacemakers or to a shock or burn of the patient if contact is made with a grounded metal surface. [1][2][3] With the advances seen in other medical specialities, we might discover new danger zones in our daily practice. The anchoring of a dental prosthesis with a magnetic device has been practiced for 20 years in Switzerland.…”

Computerized Bipolar Diathermy with Scissors and Forceps in Cutaneous Surgery

“…[7][8][9] The use of bipolar scissors facilitates dissecting and cutting, and reduces the need for clamping or ligation. The current passes only to the tissue between the scissor blades 4,5 and the tips of the forceps, 3 thus minimizing undesired collateral damage.…”

Electrosurgery, Electrocoagulation, Electrofulguration, Electrodesiccation, Electrosection, Electrocautery

“…Electrosection poses the greatest risk for pacemaker-related complications, but these may occur with all electrosurgical procedures. 25,30 An ICD is a device that sends a defibrillatory shock to the heart when it senses ventricular fibrillation or tachyarrhythmia. It is indicated for refractory ventricular tachyarrhythmias, and consists of a sensing circuit and current generator inserted in an abdominal or infraclavicular subcutaneous pocket.…”

“…Permanent ICD damage may also result if the interference is sufficient. 25 Given the potential severity of these complications, the question of their frequency becomes a pressing issue. A survey of 166 Mohs surgeons with a total of 1959 years of experience determined the number and type of complications as a result of electrosurgery in the dermatologic setting.…”