Resetting of DDD Pacemakers Due to EMI

Abstract

Multiprogrammable pacemakers have long been subject to inappropriate reprogramming and electromagnetic interference (EMI). A limited clinical experience with DDD pacing systems precludes the significance of such phenomena in these units. Since August 1981, in a series of 140 DDD systems, certain units demonstrated consistent and reproducible resetting to the back-up modes caused by electrocautery. One unit was permanently reset to the VOO mode. These observations suggest the need for renewed caution at the time of surgery; they also underscore the importance of a thorough understanding of any DDD system and careful follow-up so that such phenomena will not be misinterpreted as pacemaker failure, resulting in erroneous pacemaker removal.

Permanent Pacemaker and Implantable Cardioverter-Defibrillator Implantation

“…Its use, however, has been the subject of controversy. [17][18][19] Historically, the use of electrocautery equipment for cutting or coagulation during a pacemaker procedure was considered taboo. Concerns have been raised with respect to its causing burns at the myocardium-electrode interface, destruction of the pulse generator, and damage to the pacemaker leads.…”

Anaesthetic consideration in patients with cardiac implantable electronic devices scheduled for surgery

“…In such cases, it be may wise to monitor the pulse plethysmography from pulse oximeter waveform or arterial waveform. [ 13 14 15 16 17 18 19 ]…”

Perioperative Management of Cardiovascular Implantable Electronic Devices (CIEDs)

“…Electromagnetic interference (EMI) in the preoperative settings can interfere with the functioning of both pacemakers and ICDs, presenting a challenge to the management of these devices [8][9][10]. Although there are several potential sources of EMI, the major source is monopolar electrocautery, particularly if the source of EMI is within 6 inches (15 cm) of the generator.…”