Abstract
The high rate of utilization of cardiac implantable electronic devices (CIEDs) and the high stakes in case of malfunction makes it crucial that we understand and optimize the perioperative management of CIEDs. Several professional societies have addressed the topic. The function of CIED can be altered by electromagnetic interference (EMI), potentially causing iatrogenic adverse outcomes. There are several sources of EMI in the operating room. A comprehensive preoperative assessment for patients with CIED undergoing elective surgery should be performed. Device interrogation and appropriate reprogramming, if necessary, should be done before the surgical intervention. Reprogramming can be performed using a reprogramming machine or through magnet application in certain conditions. Several factors should be considered during the intraoperative period that are centered on continuous monitoring and preparedness for emergencies. Transcutaneous/defibrillator pads should be placed on the patient during the surgical procedure. Postoperative management includes reactivation of CIED and appropriate device interrogation to check for any malfunction during or following the surgical procedure.
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References
Kremers MS, Hammill SC, Berul CI, Koutras C, Curtis JS, Wang Y, et al. The national ICD registry report: version 2.1 including leads and pediatrics for years 2010 and 2011. Heart Rhythm. 2013;10(4):e59–65.
Pokorney SD, Miller AL, Chen AY, Thomas L, Fonarow GC, De Lemos JA, et al. Implantable cardioverter-defibrillator use among Medicare patients with low ejection fraction after acute myocardial infarction. JAMA. 2015;313(24):2433–40.
Rooke GA, Bowdle TA. Perioperative management of pacemakers and implantable cardioverter defibrillators: it’s not just about the magnet. Anesth Analg. 2013;117(2):292–4.
Schulman PM, Rozner MA, Sera V, Stecker EC. Patients with pacemaker or implantable cardioverter-defibrillator. Med Clin. 2013;97(6):1051–75.
Misiri J, Kusumoto F, Goldschlager N. Electromagnetic interference and implanted cardiac devices: the nonmedical environment (part I). Clin Cardiol. 2012;35(5):276–80.
Lau W, Corcoran SJ, Mond HG. Pacemaker tachycardia in a minute ventilation rate-adaptive pacemaker induced by electrocardiographic monitoring. Pacing Clin Electrophysiol. 2006;29(4):438–40.
Crossley GH, Poole JE, Rozner MA, Asirvatham SJ, Cheng A, Chung MK, et al. The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) expert consensus statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management. Heart Rhythm. 2011;8(7):1114–54.
Stone ME, Salter B, Fischer A. Perioperative management of patients with cardiac implantable electronic devices. Br J Anaesth. 2011;107(suppl_1):i16–26.
Schulman PM, Rozner MA. Case report: use caution when applying magnets to pacemakers or defibrillators for surgery. Anesth Analg. 2013;117(2):422–7.
Carlson T, Andrell P, Ekre O, Edvardsson N, Holmgren C, Jacobsson F, et al. Interference of transcutaneous electrical nerve stimulation with permanent ventricular stimulation: a new clinical problem? Europace. 2008;11(3):364–9.
Plakke MJ, Maisonave Y, Daley SM. Radiofrequency scanning for retained surgical items can cause electromagnetic interference and pacing inhibition if an asynchronous pacing mode is not applied. A A Case Rep. 2016;6(6):143–5.
Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL, editors. Miller’s anesthesia. Philadelphia: Elsevier Health Sciences; 2014.
Reddy VY, Exner DV, Cantillon DJ, Doshi R, Bunch TJ, Tomassoni GF, et al. Percutaneous implantation of an entirely intracardiac leadless pacemaker. N Engl J Med. 2015;373(12):1125–35.
American Society of Anesthesiologists. Practice advisory for the perioperative management of patients with cardiac implantable electronic devices: pacemakers and implantable cardioverter-defibrillators: an updated report by the American Society of Anesthesiologists task force on perioperative management of patients with cardiac implantable electronic devices. Anesthesiology. 2011;114(2):247–61.
Badrinath SS, Bhaskaran S, Sundararaj I, Rao BS, Mukesh BN. Mortality and morbidity associated with ophthalmic surgery. Ophthalmic Surg Lasers. 1995;26(6):535–41.
Pili-Floury S, Farah E, Samain E, Schauvliege F, Marty J. Perioperative outcome of pacemaker patients undergoing non-cardiac surgery. Eur J Anaesthesiol. 2008;25(6):514–6.
Mark JB. Atlas of cardiovascular monitoring. London: Churchill Livingstone; 1998.
Donnelly P, Pal N, Herity NA. Perioperative management of patients with implantable cardioverter defibrillators. Ulster Med J. 2007;76(2):66.
Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Miller’s anesthesia. Philadelphia: Elsevier Health Sciences; 2010.
Healey JS, Merchant R, Simpson C, Tang T, Beardsall M, Tung S, et al. Canadian Cardiovascular Society/Canadian Anesthesiologists’ Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices. Can J Cardiol. 2012;28(2):141–51.
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Sabra, M., Refaat, M.M. (2024). Handling Pacemakers and Implantable Cardioverter Defibrillators in the Operating Room. In: Hoballah, J.J., Kaafarani, H.M., Tsoulfas, G. (eds) Principles of Perioperative Safety and Efficiency. Springer, Cham. https://doi.org/10.1007/978-3-031-41089-5_8
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DOI: https://doi.org/10.1007/978-3-031-41089-5_8
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