ABSTRACT
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. CONCLUSION: Knowledge of the potential electrosurgical interference with ICDs and pacemakers is required to perform these procedures safely. A perioperative management plan is suggested.
Subject(s)
Defibrillators, Implantable , Dermatologic Surgical Procedures , Electrosurgery , Pacemaker, Artificial , Aged , Aged, 80 and over , Carcinoma, Basal Cell/surgery , Carcinoma, Squamous Cell/surgery , Contraindications , Electrosurgery/adverse effects , Facial Neoplasms/surgery , Humans , Male , Mohs Surgery , Preoperative Care , Skin Neoplasms/surgeryABSTRACT
Vision loss during a centrifuge run is an expected occurrence given the G-profile, physical fitness of the subject, expected visual endpoint [central light loss (CLL) or peripheral light loss (PLL)] of the experimental protocol, and the cyclic nature of the anti-G straining maneuver (AGSM). During a relatively low level G exposure, a subject experienced a unilateral loss of vision that did not resolve spontaneously upon removal of the G load. An extensive medical workup did not reveal any medical explanation for the vision loss.
