Bipolar cautery is ideal to minimize electromagnetic interference with Implantable Cardioverter Defibrillators (ICDs).
Where monopolar is used, this study employed protocolized placement of electrosurgery dispersive electrode positioning to divert return current away from the ICD. They found no interference from below-umbilicus procedures but 7% in above-umbilicus procedures and as high as 29% in cardiac surgery (using underbody Megadyne, described as alarmingly high!).
The findings support recommendations that reprogramming and suspending anti-tachycardia functions may be unnecessary in below-umbilicus procedures. However higher risk exists in above-umbilicus procedures and especially in cardiac surgery and underbody dispersive electrodes.