Pacemaker Failure to Capture Caused by Electrocautery: A Rare Pacemaker Pulse Generator Change Complication

In the advent of increasing benefits of cardiac devices, more and more implants are being done. Pacing devices reaching the end of service need to be changed. The use of electrocautery (EC) to maintain hemostasis during cardiac device implantation is efficient and safe. Device makers have variable recommendations for the use of EC. Generally, considered safe, EC has been rarely known to cause device failure. We describe a case of a dual-chamber device, pulse generator change, where EC caused a sudden, unexpected loss of pacing function that lasted for 30 seconds. This case report highlights the gaps in the process of undertaking these high-risk changes.