Pacemakers and implantable cardiac defibrillators in dermatologic surgery.
BACKGROUND
Electrosurgery used during dermatologic surgical procedures can cause malfunction of pacemakers and implantable cardiac defibrillators (ICDs), producing problems with rhythm detection, proper function, or alteration of the device. Well-documented safety data on electrosurgery in patients with cardiac devices are limited. At Mayo Clinic in Rochester, Minnesota, the Pacemaker Clinic manages all patients with pacemakers and ICDs undergoing dermatologic surgery. The preoperative and postoperative evaluations provide a unique opportunity to evaluate the safety of dermatologic surgery with electrosurgery in such patients.


OBJECTIVE
The objective was to review the evaluation and management, by an experienced cardiology team, of patients with cardiac devices undergoing dermatologic surgery and to characterize perioperative complications.


METHODS
A retrospective chart review of all patients identified with pacemakers or ICDs undergoing Mohs micrographic or dermatologic excisional surgery with electrosurgery at Mayo Clinic 2001 through 2004 were identified. Data were abstracted to identify any possible complications.


RESULTS
The 173 patients with pacemakers and 13 with ICDs undergoing dermatologic surgery had no documented complications from electrosurgery.


CONCLUSIONS
The lack of complications associated with pacemakers and ICDs with electrosurgery is reassuring. The authors support published recommendations about techniques and precautions to optimize safety during electrosurgery in patients with cardiac devices. The care of patients with ICDs in particular requires special consideration.
Matzke
Thomas J
TJ
Department of Dermatology, Olmsted Medical Center, Rochester, Minnesota, USA.
Christenson
Leslie J
LJ
Christenson
Stuart D
SD
Atanashova
Natasha
N
Otley
Clark C
CC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000628:therapy*; D017147:Defibrillators, Implantable; D004598:Electrosurgery; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods*; D016343:Monitoring, Intraoperative; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D012871:Skin Diseases / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome