Dermatologic electrosurgery in patients with implantable cardioverter-defibrillators and pacemakers.
BACKGROUND
Electrosurgery is frequently employed in the treatment of skin cancer and other dermatologic conditions in the elderly. Implantable cardioverter-defibrillators (ICDs) and pacemakers are most commonly seen in this older population. Potentially hazardous electrosurgical interference exists with the function of ICDs and pacemakers in this setting.


OBJECTIVE
Our goal is to review the potential hazards of electrosurgery in patients with ICDs and pacemakers and to suggest a perioperative management plan.


METHODS
Review of the medical literature on electrosurgical interference with ICDs and pacemakers was accomplished in addition to a case report of ventricular tachycardia during Mohs surgery on a patient with an ICD.


RESULTS
Multiple case reports and reviews from the nonder-matologic literature demonstrate that a real hazard exists.


CONCLUSIONS
Knowledge of the potential electrosurgical interference with ICDs and pacemakers is required to perform these procedures safely. A perioperative management plan is suggested.
LeVasseur
J G
JG
Department of Dermatology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas, USA.
Kennard
C D
CD
Finley
E M
EM
Muse
R K
RK
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D000075202:Contraindications; D017147:Defibrillators, Implantable; D062109:Dermatologic Surgical Procedures; D004598:Electrosurgery / Q000009:adverse effects; D005153:Facial Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D015580:Mohs Surgery; D010138:Pacemaker, Artificial; D011300:Preoperative Care; D012878:Skin Neoplasms / Q000601:surgery