Patients with permanent pacemaker can have disastrous consequences if inappropriate sensing of external electrical events during surgery. Electro cautery or diathermy should be used judiciously .
1. Aviod diathermy if possible.
2. If neccessary use only bi- polar diathermy .
3. If bipolar diathermy not available use the indifferent electrode pad away from pacing zone , behind the thigh.
Other options.
A .Use a magnet to remove the sensing function of PPM. Application of magnet converts VVI into VOO mode so that external current will not be sensed by the pacemaker and diathermy can be safely used.
B.The other option is use the magnet only if interference problem occur .Magnet should be availableas safety measure.
Dr.S.Venkatesan MD 