DERMATOLOGICAL ELECTROSURGERY IN PATIENTS WITH IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS AND PACEMAKERS

BACKGROUND. Electrosurgery is frequently employed in the treatment of skin cancer and other dermatologic conditions in the elderly. Implanta ble cardioverter-defibrillators (ICDs) and pacemakers are most commonl y 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 ele ctrosurgery in patients with ICDs and pacemakers and to suggest a peri operative management plan. METHODS. Review of the medical literature o n electrosurgical interference with ICDs and pacemakers was accomplish ed 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 nondermatologic literature demonstrate that a real ha zard exists. CONCLUSION. Knowledge of the potential electrosurgical in terference with ICDs and pacemakers is required to perform these proce dures safely. A perioperative management plan is suggested. (C) 1998 b y the American Society for Dermatologic Surgery, Inc.