Hands-on Station: Effects of Monopolar and Bipolar Electrosurgery on Cardiovascular Implantable Electrical (Pacemakers or Implanted Cardioverter Defibrillator) Devices

Abstract

The purpose of this exercise is to understand the interaction(s), primarily the creation of electromagnetic interference (EMI), between electrosurgical (ES) instruments and cardiac implantable (pacemaker (PM) or implanted cardioverter defibrillator (ICD)) devices (CIED); to demonstrate how the presumed current path from the hand tool to the dispersal pad (for ES with a monopolar instrument) can influence the creation of electromagnetic interference; and for any given ES presumed current path and instrument, (1) to evaluate the effects of electrosurgical unit (generator) power level and settings (“coag” vs. blend vs. cut) on the creation of EMI during tissue coagulation or cutting, (2) examine the effects of applying the monopolar ES hand tool to an instrument (i.e., tissue equivalent), rather than directly to tissue, (3) examine the effects of allowing the ES hand tool tip to create electrical sparking, rather than a continuous application to the tissue, (4) evaluate the extent of EMI from activation of the monopolar ES hand tool at various power levels without touching any tissue or tissue equivalent, and (5) evaluate the extent to which EMI will occur in lengthy application of ES energy vs. short bursts.