Electrosurgery-induced ventricular fibrillation during pacemaker replacement--a unique mechanism. 1996

A Aggarwal, and N E Farber, and G S Kotter, and M S Dhamee
Department of Anesthesiology, Zablocki VAMC, Milwaukee, WI 53295, USA.

Arrhythmias and pacemaker malfunction are known to occur from the use of an electrosurgical device. The present case report describes a patient with sick sinus syndrome who experienced ventricular fibrillation while undergoing surgery. During replacement of his non-functioning cardiac pacemaker under general anesthesia, electrosurgery was used to ensure hemostasis. Electric current may have stimulated myocardial leads present in the surrounding tissue, leading to ventricular fibrillation. The patient was resuscitated from the episode without any residual sequelae. Microshock and possible mechanisms that can lead to ventricular arrhythmias in patients with pacemakers during electrosurgery are discussed.

UI MeSH Term Description Entries
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D008297 Male Males
D010138 Pacemaker, Artificial A device designed to stimulate, by electric impulses, contraction of the heart muscles. It may be temporary (external) or permanent (internal or internal-external). Cardiac Pacemaker, Artificial,Artificial Cardiac Pacemaker,Artificial Cardiac Pacemakers,Artificial Pacemaker,Artificial Pacemakers,Cardiac Pacemakers, Artificial,Pacemaker, Artificial Cardiac,Pacemakers, Artificial,Pacemakers, Artificial Cardiac
D004598 Electrosurgery Division of tissues by a high-frequency current applied locally with a metal instrument or needle. (Stedman, 25th ed) Electrosurgeries
D006488 Hemostasis, Surgical Control of bleeding during or after surgery. Surgical Hemostasis,Hemostases, Surgical,Surgical Hemostases
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012804 Sick Sinus Syndrome A condition caused by dysfunctions related to the SINOATRIAL NODE including impulse generation (CARDIAC SINUS ARREST) and impulse conduction (SINOATRIAL EXIT BLOCK). It is characterized by persistent BRADYCARDIA, chronic ATRIAL FIBRILLATION, and failure to resume sinus rhythm following CARDIOVERSION. This syndrome can be congenital or acquired, particularly after surgical correction for heart defects. Sinus Node Dysfunction,Sick Sinus Node Syndrome,Sinus Node Disease,Dysfunction, Sinus Node,Dysfunctions, Sinus Node,Sinus Node Diseases,Syndrome, Sick Sinus
D014693 Ventricular Fibrillation A potentially lethal cardiac arrhythmia that is characterized by uncoordinated extremely rapid firing of electrical impulses (400-600/min) in HEART VENTRICLES. Such asynchronous ventricular quivering or fibrillation prevents any effective cardiac output and results in unconsciousness (SYNCOPE). It is one of the major electrocardiographic patterns seen with CARDIAC ARREST. Fibrillation, Ventricular,Fibrillations, Ventricular,Ventricular Fibrillations

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