Why active implants demand proactive management

What happens when a surgeon uses the monopolar instrument set on 30-W coagulation mode to create an upper midline incision in a patient with a pacemaker? Pacemaker function is interrupted, causing a heart block that results in hemodynamic instability—or at least, this is what could happen without taking the necessary precautions. Depending on the situation, this might mean opting for bipoloar instrument instead, switching to cut mode, decreasing generator power, opting for dessication over fulguration, or reorienting the instrument set’s active electrode relative to the pacemaker.