Editing Operating with implants

Cardiovascular implantable electronic devices

* Risk of electromagnetic interference when monopolar diathermy is used
** Triggering un-needed tachyarrhythmia therapy
** Electrical reset of pulse generator
** Oversensing - most common problem - either pacing inhibition or false arrhythmia detection
*** Risk greatest when current path goes near device
*** Review suggests best to only make a pacemaker asynchronous only if significant inhibition is observed, even if the patient is pacemaker-dependent
** Device reset
*** Very uncommon, can occur with therapeutic radiation
* The risk is much lower below the umbilicus, and when current path is kept away from the device (at least 6 inches), and when bursts are limited to 5 seconds or less
** Procedures on the lower extremities really shouldn't affect the pacemaker - don't need to do anything different to normal
* GI procedures with electrosurgery can cause interference
* Magnet application
** Suspends arrhythmia detection and protect the patient from inappropriate EMI sensing, which would be interpreted incorrectly by the decide as an arrhythmia
** Some devices have been programmed not to respond to the magnet!



[[Category:Operating theatre]]