What is the dermatologic preoperative evaluation and management of pacemakers?

Updated: Feb 23, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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The patient with a modern cardiac pacemaker is most likely at low risk for adverse outcomes from the use of electrosurgery. However, Leshin and McCalmont suggest the following precautions [14] :

  • Avoid electrosurgery in patients who are unstable and who are strongly dependent on the pacemaker.

  • Perioperatively, monitor the patient's pulse and level of consciousness.

  • Ground the patient with an indifferent electrode at a site that is away from the heart and the pacemaker.

  • Avoid the use of the cutting current except in settings in which cardiac monitoring and resuscitation equipment are available.

  • Use short bursts of electric current (< 5 seconds' duration).

  • Avoid surgery near the heart or the pacemaker.

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