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CASE REPORT
Year : 2011  |  Volume : 27  |  Issue : 4  |  Page : 527-530

Electromagnetic interference in a cardiac pacemaker during cauterization with the coagulating, not cutting mode


1 Department of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland, OH, USA
2 Department of Anesthesiology, Children's Memorial ­Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
3 Department of Veteran Affairs, Louis Stokes Medical Center, Cleveland, OH, USA
4 Department of Anesthesiology, Tucson, AZ, USA
5 Cleveland Clinic Spine Institute, Cleveland, OH, USA
6 Department of General Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA

Correspondence Address:
Basem Abdelmalak
Cleveland Clinic, Department of General Anesthesiology, E-31, 9500 Euclid Avenue, Cleveland, OH 44195
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.86600

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Electromagnetic interference in pacemakers has almost always been reported in association with the cutting mode of monopolar electrocautery and rarely in association with the coagulation mode. We report a case of electrocautery-induced electromagnetic interference with a DDDR pacemaker (dual-chamber paced, dual-chamber sensed, dual response to sensing, and rate modulated) in the coagulating and not cutting mode during a spine procedure. We also discuss the factors affecting intraoperative electromagnetic interference. A 74-year-old man experienced intraoperative electromagnetic interference that resulted in asystole caused by surgical electrocautery in the coagulation mode while the electrodispersive pad was placed at different locations and distances from the operating site (This electromagnetic interference did not occur during the use of the cutting mode). However, because of careful management, the outcome was favorable. Clinicians should be aware that the coagulation mode of electrocautery can cause electromagnetic interference and hemodynamic instability. Heightened vigilance and preparedness can ensure a favorable outcome.


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