Levine P A, Balady G J, Lazar H L, Belott P H, Roberts A J
Ann Thorac Surg. 1986 Mar;41(3):313-7. doi: 10.1016/s0003-4975(10)62777-4.
Electrocautery, commonly used during surgery to maintain hemostasis, can have significant detrimental effects in the paced patient. Damage to the pulse generator, reprogramming of the pacemaker, changes in the capture threshold, and ventricular fibrillation can all be induced by electrocautery. Familiarity with the particular pacemaker in use is critical in minimizing these adverse effects. Preoperative evaluation of the patient's dependence on the pacemaker and evaluation of pacemaker function should be performed and documented. We recommend close intraoperative monitoring of heart rate and rhythm, and suggest that a pacemaker programmer be on hand in the surgical suite during the operation. A postoperative check of pacemaker function should be carried out so that electrocautery-induced pacemaker malfunction will not go unnoticed or uncorrected. Three cases are presented which clearly illustrate these points.
电灼术常用于手术中以维持止血，但对使用起搏器的患者可能产生重大不利影响。电灼术可导致脉冲发生器受损、起搏器重新编程、捕捉阈值改变以及心室颤动。熟悉所使用的特定起搏器对于将这些不良反应降至最低至关重要。应进行并记录患者起搏器依赖情况：对患者对起搏器的依赖程度进行术前评估以及对起搏器功能进行评估。我们建议术中密切监测心率和心律，并建议在手术期间手术室内备有起搏器程控仪。术后应检查起搏器功能，以便电灼术引起的起搏器故障不会被忽视或未得到纠正。本文介绍了三个病例，清楚地说明了这些问题。
