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.
Key Words
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References
- The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) expert consensus statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: Facilities and patient management: This document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS).Heart Rhythm. 2011; 8: 1114-1154
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Article info
Publication history
Published online: February 12, 2021
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