Recurrent Asystole as an Electrocardiographic Artifact during Microdebrider use in Functional Endoscopic Sinus Surgery

Patadia, Monica; Bartindale, Matthew; Caballero, Nadieska

doi:10.2500/ajra.2015.29.4256

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…For instance, disturbances in cardiac monitoring equipment during microdebrider device use have been reported. Patadia et al 23 noted several false asystolic events during microdebrider use that resulted in an aborted procedure and costly diagnostic testing, ultimately thought to be due to electrical interference from a chassis leak. Other authors have noted apparent ventricular tachycardia on intraoperative electrocardiograms, also thought to be to electrical interference 24,25 .…”

Section: Discussionmentioning

confidence: 99%

Microdebrider complications in sinus surgery: Analysis of the openFDA database

Saba

Hoerter

Chang

et al. 2023

World j. otorhinolaryngol.-head neck surg.

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ObjectiveFunctional endoscopic sinus surgery is a commonly performed otolaryngologic procedure that often uses the microdebrider device for tissue removal. Given the ubiquitous nature of the instrument, we sought to better define the patterns of device failure using the postmarket surveillance openFDA database.MethodsThe openFDA database was queried for all microdebrider‐related adverse events from January 1, 2000 to November 1, 2020. Descriptive information on the nature of device failure and any associated patient injury was compiled. Reports not directly related to device failure were excluded from the analysis.ResultsA total of 641 events were included in the analysis. The most common device failure was overheating (n = 348, 54.3%), followed by material separation (n = 173, 27%), and inconsistent device activation (n = 52, 8.1%). Of the reported events, the vast majority did not result in patient harm (n = 579, 90.3%). On review of the remaining cases, only 24 events (3.7%) resulted in true harm to the patient, defined as a temporary or permanent injury or >30 min of additional anesthesia time. Of these cases, the need to reschedule surgical cases (n = 5, 0.8%), retained foreign body (n = 5, 0.8%), and thermal tissue injury (n = 3,0.5%) were the most common. Five patients suffered an injury due to surgeon error unrelated to device malfunction (n = 5, 0.8%).ConclusionsMicrodebrider device failures are extremely rare. When they do occur, less than 10% result in patient harm. In cases of patient harm related to microdebrider failure, preoperative testing of the device before use could prevent many of the reported malfunctions.

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Section: Discussionmentioning

confidence: 99%

Microdebrider complications in sinus surgery: Analysis of the openFDA database

Saba

Hoerter

Chang

et al. 2023

World j. otorhinolaryngol.-head neck surg.

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“…In a large study on epistaxis characteristics, Comelli et al 25 reported a strong inverse correlation peak during wintertime. Finally, as an important cautionary tale to all endoscopic sinus surgeons, Patadia et al 26 described an interesting case of electrocardiograph artifacts that mimic asystole from microdebrider use during ESS.…”

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confidence: 99%

Understanding the Basic Science and Augmenting the Clinical Knowledge Base of Rhinologic Disorders

Sindwani¹

2015

Am J Rhinol�Allergy

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Understanding the basic science and augmenting the clinical knowledge base of rhinologic disorders T he fields of rhinology and allergy continue to expand in detail and scope at a rapid pace. Quality studies and high-value research have pushed these disciplines toward exciting new frontiers, as motivated researchers and clinicians continue to unravel the mysteries of disorders that affect the nose and paranasal sinuses. This edition of the American Journal of Rhinology and Allergy (AJRA) is exemplary of this because the articles within augment our understanding of the basic science and clinical knowledge base of our field.We start by introducing several studies that confront one of the most-elusive issues in rhinology: the pathogenesis of chronic rhinosinusitis (CRS). The first article in this issue is a study by Shin et al. 1 that digs more deeply into nasal polyp disease. The researchers report on the molecular mechanisms of the drug pirfenidone on nasal polyp-derived fibroblasts, specifically noting transforming growth factor ␤1induced myofibroblast differentiation and extracellular matrix accumulation by regulation of Smad2/3 pathways. In a review article by Hamilos, 2 discussion turns to the pathogenesis of pediatric CRS. This article expands on the unique characteristics of host-microbial interactions, potential defects in innate antimicrobial immunity, and the role of biofilm formation. Rowan et al. 3 present a novel study that looked at the role of respiratory viruses in the microbiome of patients with CRS, which has not been well studied in the literature to date. These three studies help to hone our understanding of the complex framework of CRS and the potential factors at play in this condition.Attention then turns to treatment of CRS in a well-designed randomized controlled trial by Amali et al. 4 that looked at the anti-inflammatory effects of long-term oral macrolide therapy after endoscopic sinus surgery (ESS). Interestingly, the re-

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Loss of Pacer Spikes as electrocardiographic (EKG) Artifact Due to Microdebrider Use During Endoscopic Dacryocystorhinostomy

Pham

Setabutr²

2020

Ophthalmic Plastic &Amp; Reconstructive Surgery

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As intraoperative use of electronic equipment becomes more common, familiarity with the potential for electrocardiographic artifact generated by these instruments is increasingly important. The authors' patient underwent endoscopic dacryocystorhinostomy under general anesthesia for treatment of acute on chronic dacryocystitis secondary to acquired nasolacrimal duct obstruction. She had previously had pacemaker placement for treatment of sick sinus syndrome and low ejection fraction heart failure, and use of a microdebrider intraoperatively resulted in loss of pacer spikes and interference signal on electrocardiographic leading to placement of a magnet. Post-operatively, examination of the microdebrider cord revealed a tear that likely lead to the artifactual electrocardiographic signal influencing the decision for magnet placement. Although there were no long-term ill effects, placement of the magnet was an unnecessary intervention that may have been avoided by prompt recognition of artifactual changes that may be induced by intraoperative use of electronic instrumentation.

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Recurrent Asystole as an Electrocardiographic Artifact during Microdebrider use in Functional Endoscopic Sinus Surgery

Cited by 3 publications

References 23 publications

Microdebrider complications in sinus surgery: Analysis of the openFDA database

Microdebrider complications in sinus surgery: Analysis of the openFDA database

Understanding the Basic Science and Augmenting the Clinical Knowledge Base of Rhinologic Disorders

Loss of Pacer Spikes as electrocardiographic (EKG) Artifact Due to Microdebrider Use During Endoscopic Dacryocystorhinostomy

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