pacemaker interference by electrocautery prevented?
Electrocautery interference can be prevented by
electively reprogramming the pacemaker to asynchronous ventricular pacing in
the preoperative period. In an emer-gency, a magnet placed over the pacemaker
generator will (at least temporarily) convert the pacemaker to an asyn-chronous
pacing mode. It is important to recognize that differences exist between
manufacturers and devices, such that not all pacemakers will convert with
magnet applica-tion to a stable asynchronous mode for the duration of surgery.
It is possible that the magnet response may have been turned off or other
responses may have been programmed that do not protect from electrocautery
The use of bipolar electrocautery, where the
current enters and leaves the patient at the cauterization site through a
forceps-like device, may also prevent electro-cautery interference. (In
standard unipolar electrocautery, the current enters the patient through the
cautery instru-ment tip and returns to the cautery machine through a return
pad, which is often inaccurately referred to as a “grounding” pad.)