Singleton MJ, Fernando RJ, Bhave P, Clark JR, Johnson JE, Whalen SP, Royster RL. Inappropriate Implantable Cardioverter-Defibrillator Therapy With the Use of an Underbody Electrosurgery Dispersive Electrode.
J Cardiothorac Vasc Anesth 2021;
36:236-241. [PMID:
33745836 DOI:
10.1053/j.jvca.2021.02.031]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/11/2022]
Abstract
Perioperative management of implantable cardioverter-defibrillators is an important part of anesthetic care. Society recommendations and expert consensus statements exist to aid clinicians, and they have identified the umbilicus as an important landmark in decision-making. Implantable cardioverter-defibrillator antitachycardia therapy may not need to be deactivated for infraumbilical surgery because electromagnetic interference is unlikely to occur. The authors present two cases in which inappropriate antitachycardia therapy occurred intraoperatively with use of an underbody dispersive electrode, even though both surgeries were infraumbilical. The authors also present two cadaver models to demonstrate how monopolar electrosurgery below the umbilicus is sensed using both traditional and underbody dispersive electrosurgical return electrodes.
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