Key result
Monopolar electrocautery linked to reversible asystole in a patient with a DDD pacemaker.
Why the study?
Monopolar electrocautery produces significant electromagnetic interference to implanted cardiac devices, potentially causing complications such as asystole.
Does monopolar electrocautery cause asystole in a pediatric patient with a DDD pacemaker?
Case Report (n=1)
Does monopolar electrocautery cause asystole in a pediatric patient with a DDD pacemaker?
Monopolar electrocautery can cause significant electromagnetic interference resulting in asystole in patients with implanted pacemakers.
Answers are grounded in this paper and cite their sources.
Monopolar electrocautery may induce asystole in pediatric DDD pacemaker patients during scoliosis surgery; hypothesis-generating for device-specific perioperative protocols.
Pediatric heart condition management may include a variety of implanted cardiac devices. Monopolar electrocautery (Bovie) produces significant electromagnetic interference to these devices. This interference can alter the function of a cardiac generator resulting in a variety of complications including impaired cardiac output and asystole. We report the case of a 16 plus 2-year-old girl who presented with idiopathic scoliosis and a past medical history significant for complete congenital heart block treated with a DDD*** pacemaker. During surgery, the use monopolar electrocautery caused the patient to develop asystole and loss of pulsatile blood pressure. Electrocautery was subsequently terminated, the patient then returned to a normal sinus rhythm and blood pressure normalized.
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Bales et al. (2007) conducted a case report in Idiopathic scoliosis and complete congenital heart block (n=1). Monopolar electrocautery was evaluated on Asystole and loss of pulsatile blood pressure. Monopolar electrocautery during scoliosis surgery caused asystole and loss of pulsatile blood pressure in a 16-year-old girl with a DDD pacemaker, which resolved upon termination of electrocautery.
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