Cardiology>>>>>Assessment for Surgery
Question 4#

Which one of the following statements is not true regarding management of a pacemaker/implantable cardiac defibrillator during non-cardiac surgery?

a. Avoid surgical diathermy/electrocautery where possible
b. If surgical diathermy/electrocautery is essential, monopolar surgical diathermy/ electrocautery is preferred
c. Programme an ICD prior to surgery to a ‘monitor’ only mode
d. Programme a pacemaker to avoid or minimize inappropriate inhibition, or high rate pacing through the ‘tracking’ of electrical interference
e. In emergency situations, consider positioning a clinical magnet over the ICD/pacemaker implant site to inhibit shock therapy (for ICDs) or cause asynchronous pacing (for pacemakers)

Correct Answer is B


Bipolar surgical diathermy/electrocautery is preferred. The other statements are all recommended measures. The device should always be checked before and after surgery to ensure appropriate functioning.