Thoracic RFA in pacemaker patient

[SpineandWine]

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Patient has pacemaker, not pacemaker dependent.
Can I do thoracic RFA- if interference (evidenced by pulse ox), I can turn off RF machine

Seems most are not concerned


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[lobelsteve]

I would do it. Place ground pad immediately adjacent to field.

 

[callmeanesthesia]

I do it bipolar. 2 needles on each side, placed at upper and lower lateral pedicle shadow, or upper and lower medial transverse process if it’s visible. I’ve done it by marking off skin over the target at each level, then putting one needle straight down, and one angled down from the entry site above, burning the lower level, then redirecting so the middle needle is straight down and the lower needle is angled up to the middle level, burning, then moving the lower needle to the top and angling up the middle needle, then burning the top level (if that makes any sense) meaning still only 3 skin entry sites per side.

 

[Ducttape]

talk to pacemaker rep about turning off the pacemaker during the procedure for extra safety

 

[pmrmd]

I’d do it. Follow pulse on monitoring device if you’re concerned.