[Reprogramming of a pacemaker induced by electrocautery]. / Reprogrammation d'un stimulateur cardiaque induite par le bistouri électrique.

ABSTRACT

A case is reported of reprogramming of a ventricular unipolar permanent pacemaker induced by electrocautery during biliary surgery. After skin incision and use of the unipolar electrosurgery unit, the CPI model 505 multiprogrammable pulse generator previously set at 70 b X min-1 abruptly fired at 120 b X min-1. Application of a magnet over the pacemaker reduced the heart rate to 100 b X min-1. After surgery, the pulse generator was successfully reprogrammed to a rate of 65 b X min-1. Based on the analysis of this case and of previous reports, it is suggested, so as to avoid such complications, that the unipolar electrocautery be avoided when the surgical field is near the pulse generator or lead that the bipolar electrocautery be preferred; that a magnet and non-invasive programmer be available during and after surgery; and that a postoperative assessment of the pulse generator be carried out.