Cervical RFA with ICD defibrillator

[donaldduck]

Do y'all put magnets over the ICD if having a cervical RFA? Also, what is the consensus when doing SCS with cardiac devices?

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[Ducttape]

not over an ICD.

get the rep to turn it off.


if you do SCS with cardiac devices, id suggest you contact the cardiac device rep and generally speaking use the same company's stim product.

 

[callmeanesthesia]

I do bipolar if AICD, or if pacemaker and cervical or thoracic RF. I posted description of my technique recently but I can’t recall what thread at the moment.

 

[so55b]

I do bipolar too. Not putting the grounding pad just in case

 

[oneforfighting]

I do bipolar too. Not putting the grounding pad just in case

Why would it matter whether you place the grounding pad?

 

[so55b]

Why would it matter whether you place the grounding pad?

It doesn’t matter but just in case my staff or I forget and do the unipolar burn. My staff used to place the grounding pad either uni or bipolar and it is a waste.

 

[Timeoutofmind]

Every ICD and pacer behaves differently if you put a magnet over it so I would reach out to the cardiologist to get a formal recommendation for C RF. But 90% of the time they will just tell you to put a magnet over it during the case and remove it afterwards. This will typically deactivate the AICD function and not influence the pacer function. They will typically not recommend the device needs to be interrogated afterwards, but sometimes they may.

As far as the ICD plus Scs…
I explain to the patient there is some very small but real risk that the stimulation from the stimulator could inappropriately inhibit or trigger ICD therapy, which could be catastrophic. However, quite a bit of case reports, etc. and this is commonly done without any issue in the real world.
So I just would have the ICD Rep present at the trial and when you turn the stimulator on have them verify no interference. I’ve never heard of their actually been interference. And then if that is the case OK to proceed and I don’t have them come for the permanent…

 

[kstarm]

Are people doing anything for lumbar in these cases or just going ahead without clearance

 

[Timeoutofmind]

Anything below umbilicus no precautions needed

 

[painfree23]

Is this really a concern even on new aicds?