Cardiac pacemaker induced ventricular fibrillation during surgical diathermy

Anaesthesia and Intensive Care
H J Orland, D Jones

Abstract

Two demand pacemakers were observed to repeatedly fibrillate the heart during clinical surgery employing diathermy. Marked hypotension associated with a rapid, irregular venticular action was observed in another patient who had a fixed rate pacemaker implanted. Pacemakers were tested with function generators over a range of frequencies and some increased their rate to between 200-600 impulse/min. Animal experiments confirmed that, contrary to manufacturers advice, surgical diathermy produces myocardial fibrillation in the presence of some pacemakers. Mechanisms of these effects and their clinical significance are discussed.

References

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Citations

May 22, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Werner Irnich
Sep 1, 1990·Pacing and Clinical Electrophysiology : PACE·L I Heller
Mar 1, 1986·Canadian Anaesthetists' Society Journal·B MilneP J Westra
Jun 27, 2006·Annals of Plastic Surgery·Jeffrey C DawesAnne M Gillis
May 1, 1981·Pacing and Clinical Electrophysiology : PACE·H G Mond, J G Sloman

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