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Inappropriate defibrillator shock during gynecologic electrosurgery

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Presentation on theme: "Inappropriate defibrillator shock during gynecologic electrosurgery"— Presentation transcript:

1 Inappropriate defibrillator shock during gynecologic electrosurgery
Rachel M. Kaplan, MD, Jeremiah Wasserlauf, MD, MS, Rachel H. Bandi, MD, Elizabeth M. Lange, MD, Bradley P. Knight, MD, FHRS, Susan S. Kim, MD  HeartRhythm Case Reports  Volume 4, Issue 7, Pages (July 2018) DOI: /j.hrcr Copyright © 2017 Heart Rhythm Society Terms and Conditions

2 Figure 1 Electrograms (EGMs) showing electromagnetic interference (EMI) detected as ventricular fibrillation (VF) by the implantable cardioverter-defibrillator. A = right atrial lead EGMs, true bipolar sensing; V = right ventricular (RV) lead EGMs, integrated-bipolar sensing from the tip electrode to the RV coil; Shock = “shock” EGM, a far-field signal recorded from the pulse generator to the RV coil. Note the only very subtle noise on the shock EGM, in contrast to the large-amplitude EMI seen on the RV EGM. HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

3 Figure 2 Electrograms (EGMs) showing electromagnetic interference (EMI) that was sensed as ventricular tachycardia / ventricular fibrillation but not treated owing to presence of a magnet. A = right atrial lead EGMs, true bipolar sensing; V = right ventricular (RV) lead EGMs, integrated-bipolar sensing from the tip electrode to the RV coil; Shock = “shock” EGM, a far-field signal recorded from the pulse generator to the RV coil. Again, note the only very subtle noise on the shock EGM, in contrast to the large-amplitude EMI seen on the RV EGM. HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

4 Figure 3 Computed tomography scout film demonstrating proximity of the left ventricular assist device (LVAD) to the right ventricular (RV) lead and the location of aortic graft. Note that the caudal end of the aortic graft extends well below the iliac crest. Black arrow indicates the RV lead tip. Note proximity to the LVAD pump. White arrow indicates the top of the aortic graft. HeartRhythm Case Reports 2018 4, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

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