The Importance of Electrosurgery Pad Placement on Pacemaker Patients

The first line of the Hippocratic Oath is, “First, do no harm.”  At Bovie Medical, we are committed to medical professionals upholding this rule.  We are here to help you understand not only the benefits that come with electrosurgery and the use of our electrosugery accessories, but also to address legitimate concerns you may have.

First, why electrosurgery?

The answer is simple.  The use of electrosurgery provides a number of benefits for both doctor and patient.  These include:

  • The ability to coagulate on the spot

  • Reduction of hemorrhage risk

  • The potential for reduced recovery time for patients

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Why the concern?

As you know, the heart has its own internal electrical system.  The pacemaker was designed to help correct faults in this system.  At the advent of electrosurgical technology, concerns about interference between electrosurgery accessories and pacemakers arose almost immediately.

In the past, electrosurgery involved the use of single-pad return electrodes.  With single-pad returns, doctors had no way of monitoring the system for unsafe contacts.  Electrosurgery today involves the use of a number of electrosurgery accessories to reduce risk.  These include dual-pad return electrodes, allowing for fail-safe features on ElectroSurgical Units (ESUs).  If the system detects a faulty contact, the system will shut down to prevent injury to the patient.

Any electronic or metal devices in a patient’s body pose extra risks for a patient undergoing electrosurgery.  Pacemaker-mediated tachycardia, or heart rate accelerated beyond the normal range, is one of the more common concerns.  However, as we shall see, safe practices ensure a reduction in the risk potential.

Safe practices

A recent study conducted at the Brown University School of Medicine found that electrosurgery rarely results in significant interference with pacemakers when surgeons follow routine precautions and procedures.

  • The grounding or return pad must be placed as far away from the pacemaker or ICD as possible.

  • The return electrode must be placed on the side of the body opposite the surgical site, at a location between the patient’s implant and the point of surgery.

  • The anesthesiologist should carefully monitor the pacemaker’s activity and be prepared to reset it to its asynchronous mode.

  • The anesthesiologist should be equipped with Isoproterenol for any electrosurgery involving patients with pacemakers.

Our company’s namesake, William T. Bovie, was a pioneer in the development of electrosurgical technology.  We are not only committed to upholding his name as a symbol of excellence and innovation, but also to enabling medical professionals to provide the best possible care for their patients.  To that end, we offer the top electrosurgery accessories and products in the field.

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