• Vasudha Goel, Hariharan Shankar, Siva K Mulpuru, and Harish Ramakrishna.
• From the Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota.
• A A Pract. 2020 Sep 1; 14 (11): e01286.

AbstractA 52-year-old woman with a history of cervical spondylosis, nonischemic dilated cardiomyopathy, and complete heart block with implantation of a cardiac resynchronization therapy defibrillator (Inogen XR, Boston Scientific, Natick, MA) underwent bilateral fluoroscopy-guided radiofrequency ablation of the medial branch nerves at C4, C5, and C6 levels at an ambulatory surgery center. After completion of the seemingly routine procedure, several alerts, including 1 inappropriate shock, were received via Boston Scientific's remote monitoring system. Tracings also showed that pacing inhibition occurred. When performing radiofrequency ablation in patients with a cardiac implantable electronic device, it is imperative to follow published best practice recommendations to minimize the risk of adverse events.

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