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Diathermy and pacemaker safety — FRCA Primary MCQ

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HardPhysics and Clinical MeasurementDiathermy and pacemaker safetyFRCA Primary

A pacemaker-dependent patient has a transvenous ICD and requires monopolar surgery above the umbilicus. Why is magnet application alone an incomplete plan?

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Correct answer: A — Tachytherapy stops; programmed bradycardia pacing remains unchanged

The best answer is “Tachytherapy stops; programmed bradycardia pacing remains unchanged”. A magnet over a transvenous ICD generally inhibits tachyarrhythmia detection and therapy but does not alter its bradycardia pacing mode. A pacemaker-dependent patient exposed to electromagnetic interference may therefore still have pacing inhibited and usually needs an explicit reprogramming plan, monitoring and restoration of therapies afterwards.

Reference: British Heart Rhythm Society, Guidelines for the peri-operative management of people with cardiac implantable electronic devices: https://doi.org/10.1111/anae.15728