2004
DOI: 10.1111/j.1524-4725.2004.30308.x
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Mohs Micrographic Surgery in a Patient with a Deep Brain Stimulator: A Review of the Literature on Implantable Electrical Devices

Abstract: Patients with implanted electrical devices are subject to electromagnetic interference during an electrosurgical procedure. Care must be taken in this expanding patient population during a Mohs surgical procedure.

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Cited by 22 publications
(17 citation statements)
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References 95 publications
(248 reference statements)
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“…Patients are subject to electromagnetic interference during an electrosurgical procedure; in one Vol 47 No 5 report, to minimize electromagnetic interference, homeostasis was obtained with the aid of a battery-operated heat-generating handheld electrocautery device. 15) The choice of the ICD ventricular lead may also influence whether the device senses the deep brain stimulator. Single coil ICD leads have a true bipolar electrode at the tip, which facilitates better sensing at the endocardial interface.…”
Section: Discussionmentioning
confidence: 99%
“…Patients are subject to electromagnetic interference during an electrosurgical procedure; in one Vol 47 No 5 report, to minimize electromagnetic interference, homeostasis was obtained with the aid of a battery-operated heat-generating handheld electrocautery device. 15) The choice of the ICD ventricular lead may also influence whether the device senses the deep brain stimulator. Single coil ICD leads have a true bipolar electrode at the tip, which facilitates better sensing at the endocardial interface.…”
Section: Discussionmentioning
confidence: 99%
“…If the patient complains of severe pain at the junction between the electrode and the lead extender, simple division of the electrode distal to the junction will resolve the problem. There is little guidance available regarding the perioperative anesthetic management of patients with SCS, but experience with deep brain stimulators, which use a similar technology, may be relevant [15-17]. Artifacts on electrocardiography have been noted during SCS, deep brain stimulation and transcutaneous nerve stimulation [18].…”
Section: Discussionmentioning
confidence: 99%
“…During Mohs surgery using a biterminal electrosurgery system with a monopolar electrode, a patient with a deep brain stimulator experienced immediate “electric shock.” 10 In that case, symptoms were alleviated with appropriate positioning of the dispersive plate and the use of a bipolar electrode. A second case report demonstrated the safety of true electrocautery in the setting of a deep brain stimulator 11 . Cochlear implants are also sensitive to EMI.…”
Section: Potential Emi In Noncardiac Medical Devicesmentioning
confidence: 97%