Frequency of pacemaker malfunction associated with monopolar electrosurgery during pulse generator replacement or upgrade surgery

Yun Lin, Daniel P. Melby, Balaji Krishnan, Selcuk Adabag, Venkatakrishna N Tholakanahalli, Jian-Ming Li

Research output: Contribution to journalArticle

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Abstract

Purpose: The aim of this study is to investigate the frequency of electrosurgery-related pacemaker malfunction. Methods: A retrospective study was conducted to investigate electrosurgery-related pacemaker malfunction in consecutive patients undergoing pulse generator (PG) replacement or upgrade from two large hospitals in Minneapolis, MN between January 2011 and January 2014. The occurrence of this pacemaker malfunction was then studied by using MAUDE database for all four major device vendors. Results: A total of 1398 consecutive patients from 2 large tertiary referral centers in Minneapolis, MN undergoing PG replacement or upgrade surgery were retrospectively studied. Four patients (0.3% of all patients), all with pacemakers from St Jude Medical (2.8%, 4 of 142) had output failure or inappropriately low pacing rate below 30 bpm during electrosurgery, despite being programmed in an asynchronous mode. During the same period, 1174 cases of pacemaker malfunctions were reported on the same models in MAUDE database, 37 of which (3.2%) were electrosurgery-related. Twenty-four cases (65%) had output failure or inappropriate low pacing rate. The distribution of adverse events was loss of pacing (59.5%), reversion to backup pacing (32.4%), inappropriate low pacing rate (5.4%), and ventricular fibrillation (2.7%). The majority of these (78.5%) occurred during PG replacement at ERI or upgrade surgery. No electrosurgery-related malfunction was found in MAUDE database on 862 pacemaker malfunction cases during the same period from other vendors. Conclusions: Electrosurgery during PG replacement or upgrade surgery can trigger output failure or inappropriate low pacing rate in certain models of modern pacemakers. Cautions should be taken for pacemaker-dependent patients.

Original languageEnglish (US)
Pages (from-to)205-209
Number of pages5
JournalJournal of Interventional Cardiac Electrophysiology
Volume49
Issue number2
DOIs
StatePublished - Aug 1 2017

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Electrosurgery
Databases
Ventricular Fibrillation
Tertiary Care Centers
Retrospective Studies
Equipment and Supplies

Keywords

  • Asystole
  • Electromagnetic interference
  • Electrosurgery
  • Pacemaker replacement

Cite this

Frequency of pacemaker malfunction associated with monopolar electrosurgery during pulse generator replacement or upgrade surgery. / Lin, Yun; Melby, Daniel P.; Krishnan, Balaji; Adabag, Selcuk; Tholakanahalli, Venkatakrishna N; Li, Jian-Ming.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 49, No. 2, 01.08.2017, p. 205-209.

Research output: Contribution to journalArticle

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abstract = "Purpose: The aim of this study is to investigate the frequency of electrosurgery-related pacemaker malfunction. Methods: A retrospective study was conducted to investigate electrosurgery-related pacemaker malfunction in consecutive patients undergoing pulse generator (PG) replacement or upgrade from two large hospitals in Minneapolis, MN between January 2011 and January 2014. The occurrence of this pacemaker malfunction was then studied by using MAUDE database for all four major device vendors. Results: A total of 1398 consecutive patients from 2 large tertiary referral centers in Minneapolis, MN undergoing PG replacement or upgrade surgery were retrospectively studied. Four patients (0.3{\%} of all patients), all with pacemakers from St Jude Medical (2.8{\%}, 4 of 142) had output failure or inappropriately low pacing rate below 30 bpm during electrosurgery, despite being programmed in an asynchronous mode. During the same period, 1174 cases of pacemaker malfunctions were reported on the same models in MAUDE database, 37 of which (3.2{\%}) were electrosurgery-related. Twenty-four cases (65{\%}) had output failure or inappropriate low pacing rate. The distribution of adverse events was loss of pacing (59.5{\%}), reversion to backup pacing (32.4{\%}), inappropriate low pacing rate (5.4{\%}), and ventricular fibrillation (2.7{\%}). The majority of these (78.5{\%}) occurred during PG replacement at ERI or upgrade surgery. No electrosurgery-related malfunction was found in MAUDE database on 862 pacemaker malfunction cases during the same period from other vendors. Conclusions: Electrosurgery during PG replacement or upgrade surgery can trigger output failure or inappropriate low pacing rate in certain models of modern pacemakers. Cautions should be taken for pacemaker-dependent patients.",
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T1 - Frequency of pacemaker malfunction associated with monopolar electrosurgery during pulse generator replacement or upgrade surgery

AU - Lin, Yun

AU - Melby, Daniel P.

AU - Krishnan, Balaji

AU - Adabag, Selcuk

AU - Tholakanahalli, Venkatakrishna N

AU - Li, Jian-Ming

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N2 - Purpose: The aim of this study is to investigate the frequency of electrosurgery-related pacemaker malfunction. Methods: A retrospective study was conducted to investigate electrosurgery-related pacemaker malfunction in consecutive patients undergoing pulse generator (PG) replacement or upgrade from two large hospitals in Minneapolis, MN between January 2011 and January 2014. The occurrence of this pacemaker malfunction was then studied by using MAUDE database for all four major device vendors. Results: A total of 1398 consecutive patients from 2 large tertiary referral centers in Minneapolis, MN undergoing PG replacement or upgrade surgery were retrospectively studied. Four patients (0.3% of all patients), all with pacemakers from St Jude Medical (2.8%, 4 of 142) had output failure or inappropriately low pacing rate below 30 bpm during electrosurgery, despite being programmed in an asynchronous mode. During the same period, 1174 cases of pacemaker malfunctions were reported on the same models in MAUDE database, 37 of which (3.2%) were electrosurgery-related. Twenty-four cases (65%) had output failure or inappropriate low pacing rate. The distribution of adverse events was loss of pacing (59.5%), reversion to backup pacing (32.4%), inappropriate low pacing rate (5.4%), and ventricular fibrillation (2.7%). The majority of these (78.5%) occurred during PG replacement at ERI or upgrade surgery. No electrosurgery-related malfunction was found in MAUDE database on 862 pacemaker malfunction cases during the same period from other vendors. Conclusions: Electrosurgery during PG replacement or upgrade surgery can trigger output failure or inappropriate low pacing rate in certain models of modern pacemakers. Cautions should be taken for pacemaker-dependent patients.

AB - Purpose: The aim of this study is to investigate the frequency of electrosurgery-related pacemaker malfunction. Methods: A retrospective study was conducted to investigate electrosurgery-related pacemaker malfunction in consecutive patients undergoing pulse generator (PG) replacement or upgrade from two large hospitals in Minneapolis, MN between January 2011 and January 2014. The occurrence of this pacemaker malfunction was then studied by using MAUDE database for all four major device vendors. Results: A total of 1398 consecutive patients from 2 large tertiary referral centers in Minneapolis, MN undergoing PG replacement or upgrade surgery were retrospectively studied. Four patients (0.3% of all patients), all with pacemakers from St Jude Medical (2.8%, 4 of 142) had output failure or inappropriately low pacing rate below 30 bpm during electrosurgery, despite being programmed in an asynchronous mode. During the same period, 1174 cases of pacemaker malfunctions were reported on the same models in MAUDE database, 37 of which (3.2%) were electrosurgery-related. Twenty-four cases (65%) had output failure or inappropriate low pacing rate. The distribution of adverse events was loss of pacing (59.5%), reversion to backup pacing (32.4%), inappropriate low pacing rate (5.4%), and ventricular fibrillation (2.7%). The majority of these (78.5%) occurred during PG replacement at ERI or upgrade surgery. No electrosurgery-related malfunction was found in MAUDE database on 862 pacemaker malfunction cases during the same period from other vendors. Conclusions: Electrosurgery during PG replacement or upgrade surgery can trigger output failure or inappropriate low pacing rate in certain models of modern pacemakers. Cautions should be taken for pacemaker-dependent patients.

KW - Asystole

KW - Electromagnetic interference

KW - Electrosurgery

KW - Pacemaker replacement

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