Pacemakers and Implantable Cardiac Defibrillators in Dermatologic Surgery

Matzke, Thomas; Christenson, Leslie J.; Christenson, Stuart D.; Atanashova, Natasha; Otley, Clark C.

doi:10.1111/j.1524-4725.2006.32257.x

Cited by 20 publications

(16 citation statements)

References 23 publications

(44 reference statements)

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“…However, a consistent finding among the studies was that a low anaerobic threshold was predictive of perioperative cardiovascular complications, 171,173,177 postoperative death, 172,174,175 or midterm and late death after surgery. 174,179,180 An anaerobic threshold of approximately 10 mL O 2 /kg/ min was proposed as the optimal discrimination point, with a range in these studies of 9.9 mL O 2 /kg/min to 11 mL O 2 / kg/min. Although exercise tolerance can be estimated from instruments such as the DASI 133 or the incremental shuttle walk test, in 1 study, a significant number of patients with poor performance by these measures had satisfactory peak oxygen consumption and anaerobic threshold on cardiopulmonary exercise testing.…”

Section: Exercise Stress Testing For Myocardialmentioning

confidence: 99%

“…See Cardiopulmonary exercise testing has been studied in different settings, including before abdominal aortic aneurysm surgery [172][173][174]180 ; major abdominal surgery (including abdominal aortic aneurysm resection) [175][176][177] ; hepatobiliary surgery 178 ; complex hepatic resection 171 ; lung resection 181 ; and colorectal, bladder, or kidney cancer surgery. 179 These studies varied in patient population, definition of perioperative complications, and what was done with the results of preoperative testing, including decisions about the appropriateness of proceeding with surgery.…”

Section: Exercise Stress Testing For Myocardialmentioning

confidence: 99%

See 1 more Smart Citation

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

Fleisher¹,

Fleischmann²,

Auerbach³

et al. 2014

Circulation

913

495

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Section: Exercise Stress Testing For Myocardialmentioning

confidence: 99%

Section: Exercise Stress Testing For Myocardialmentioning

confidence: 99%

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

Fleisher¹,

Fleischmann²,

Auerbach³

et al. 2014

Circulation

913

495

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“…A survey by El-Gamal et al (2001) found that though no major adverse outcomes were reported by cutaneous surgeons using electrosurgical equipment, cardiac complications such as skipped beats or improper firing of an ICD were each seen at rates between 10 and 30% during dermatological procedures on the chest wall. Matzke et al (2006) performed a retrospective review at the Mayo Clinic of 173 patients with pacemakers and 13 with ICDs who underwent dermatologic surgery; the authors concluded that there were no documented complications related to bipolar electrosurgery.…”

Section: Complications From Pacing Wiresmentioning

confidence: 99%

Dermatologic surgery on the chest wall in patients with a cardiac surgery history: a review of material that may be encountered intraoperatively, including potential complications and suggestions for proceeding safely

Bucher

Kim

Givan³

et al. 2016

International Journal of Women's Dermatology

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BackgroundThoracic surgical procedures and the use of cardiac devices such as pacemakers are becoming increasingly prevalent in the population. As such, dermatologists may have a greater likelihood of encountering previously implanted or abandoned surgical material in the course of dermatologic surgery on the chest wall. A basic understanding of the wire types and the tunneling paths utilized in such procedures is important in accurately anticipating the presence of these wires to effectively manage any chance encounters.ObjectiveWe present a review on temporary epicardial pacing wires, temporary transvenous pacing wires, pacemaker leads, and surgical steel sutures in the context of dermatologic surgery.MethodsA literature review was performed on frequently used wire material in patients with a history of cardiac surgery as well as related dermatologic complications from these materials.Results & ConclusionDermatologic surgeons should particularly be aware that temporary epicardial pacing wires and pacemaker leads are not uncommonly abandoned in the chest wall of many patients. All patients with a cardiac surgery history should be questioned about possible retained wires. If wire material is encountered intraoperatively, immediately stop the procedure and do not attempt further manipulation of the wire until suggested steps are taken to ascertain the wire type.

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“…A retrospective review of 173 patients with a pacemaker and 13 with an ICD who underwent Mohs or dermatologic excisional surgery involving electrosurgery was performed at the Mayo Clinic. 45 All patients had preoperative cardiology evaluation or device information reviewed by a staff member who deemed preoperative cardiology consultation unnecessary. Twelve of the 13 patients with an ICD underwent preoperative device deactivation with continuous intraoperative monitoring until postoperative device reactivation.…”

Section: Large Modern Series Of Emi In Cardiac Implantsmentioning

confidence: 99%

Electrosurgery and Implantable Electronic Devices: Review and Implications for Office-Based Procedures

Voutsalath¹,

Bichakjian²,

Pelosi³

et al. 2011

Dermatologic Surgery

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The authors have indicated no significant interest with commercial supporters.T he number of patients with implantable electronic devices (IEDs) is growing as indications for a myriad of cardiac and neurological disorders that cannot be managed using medication alone expand. 1 These devices include gastric and cardiac pacemakers, implantable cardioverter defibrillators, cochlear implants, and a range of stimulators of the deep brain, vagal nerve, sacral nerve, phrenic nerve, spinal cord, and bone. Encountering patients with an IED who present for office-based procedures is becoming increasingly common. Electromagnetic interference (EMI) during routine procedures has been reported to be associated with inappropriate functioning of IEDs. 2 Adverse effects of performing electrosurgery on patients with IEDs pose a patient safety risk. Medical and manufacturer reports have primarily focused on larger electrosurgical equipment used in hospitals and their effect on IEDs. Our purpose was to provide a clinical review of commonly encountered IEDs, their clinical indications, potential interference with officebased electrosurgical equipment, and recommendations to prevent complications and injury. IEDs: Clinical Indications Cardiac PacemakersAlthough pacemaker technology has advanced since the first one was implanted in 1958, 3 common indications are still symptomatic bradyarrhythmias, such as sinus node dysfunction and heart block. A pacemaker consists of a battery-powered generator connected to electronic pacing wires inserted intravenously to the right-side chambers of the heart. 4 The earliest devices were asynchronous devices, pacing the heart at a fixed rate regardless of the patient's underlying rhythm and sometimes causing symptomatic hemodynamic consequences. The latest models are demand pacemakers that sense the heart's intrinsic rhythm and inhibit pacing in the same chamber or trigger pacing in another cardiac chamber. 5,6 These devices also have sophisticated timing features to optimize heart rates and even treat some atrial arrhythmias. Implantable Cardioverter DefibrillatorsImplantable cardioverter defibrillators (ICDs) have had a profound effect on patients with ventricular tachyarrhythmias and those at risk for sudden cardiac death. 7 ICDs are programmed to treat lifethreatening ventricular arrhythmias with rapid overdrive pacing or an internal defibrillator shock. These patients most commonly have severe acquired, inherited, or idiopathic forms of cardiomyopathy. Indications continue to expand to include asymptomatic patients with low ejection fractions at risk of sudden death. Similar to pacemakers, these devices

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Pacemakers and Implantable Cardiac Defibrillators in Dermatologic Surgery

Cited by 20 publications

References 23 publications

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

Dermatologic surgery on the chest wall in patients with a cardiac surgery history: a review of material that may be encountered intraoperatively, including potential complications and suggestions for proceeding safely

Electrosurgery and Implantable Electronic Devices: Review and Implications for Office-Based Procedures

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