[Interaction between electrocautery and a pacemaker]

Abstract

Following a new case of inhibition of a sentinel pacemaker by the cutting current of an electrocoagulator during endoscopic urologic surgery, the mechanism of this complication is recalled. The non-selectivity of the pacemaker detector circuit is responsible for interpreting the electrical disturbances due to the electrocoagulator as cardiac activity. The problems seen with other types of stimulators are discussed, especially programmable stimulation where the use of a magnet can lead to variations in the stimulator frequency. The stimulating wire can also be responsible for accidents, such as myocardial burns, and rhythm disturbances. The safety rules for the use of the electrocoagulator in patients with a non programmable sentinel pacemaker.