Aasim Murtaza, Umran Sarwar
Bradford Teaching Hospitals Foundation Trust, Bradford, United Kingdom
- Diathermy cautery is an essential tool for safe and effective operating in day-case surgery.
- Diathermy is a known risk-factor which can interfere with some Cardiac Implantable Electronic Devices (CIEDs) causing morbidity and mortality.
- Confusion persists amongst Health-Care Professionals on how to manage patients with CIEDs, causing unnecessary delays/cancellations.
- This poster aims to clarify the recommended management to optimise safe day-case surgery.
- A review of our Trusts peri/intra/post-operative policy for patients with CIEDs, including: Permanent Pacemakers (PPM), Implantable Cardioverter Defibrillators (ICD) and Implantable Loupe Recorders (ILR).
- ICDs: Need to be programmed to ‘monitor only’ immediately pre-operatively - the patient is unprotected from ventricular arrhythmias and requires continuous cardiac monitoring intra-operatively and reprogramming immediately after the procedure.
- PPMs: A ‘dependent’ PPM requires reprogramming before the operation. If ‘non-dependent’ no intervention is required.
- If operating directly over the pacemaker site, asynchronous mode needs to be selected. This results in the device being unable to sense active change.
- ILRs: No risk of interaction between diathermy and the device. No adjustments required.
- The use bipolar diathermy is favoured over monopolar devices. Short bursts of the diathermy should be used as and when needed.
- Understanding the process and rationale for patients who have CIEDs is key to ensuring patients are able to undergo operative procedures in a safe and effective manner which avoids unnecessary delays and cancellations on the day of operation.
- We present a safe and effective algorithm that can be used by health-care professionals.