This case report provides the first description of a magnetized surgical instrument (Weitlaner retractor) triggering an unintended automatic magnet response in a pacemaker intraoperatively, highlighting the need for awareness and routine demagnetization of surgical tools.
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Clinicians should check surgical tools for unintended magnetization to prevent unexpected CIED reprogramming; this single case leaves open its true incidence.
Cardiac electronic implantable devices (CIEDs) utilize automatic magnetic response, a feature that allows for immediate and simple device reprogramming when exposed to a magnetic field. Placing a magnet over a CIED reprograms pacemakers to an asynchronous pacing mode and turns off tachycardia detections in implantable cardioverters-defibrillators (ICDs). This reprogramming is often strategically employed peri-operatively when electrocautery close to the leads is anticipated, as electric current delivered close to the device may inadvertently cause inappropriate pacemaker inhibition or inappropriate delivery of tachycardia therapies in ICDs due to electromagnetic interference (EMI).
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Kondamudi et al. (2025) studied this question.
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