Abstract
Patients with pacemakers or internal cardioverter-defibrillators (ICDs) are at risk for device malfunction on exposure to electromagnetic interference (EMI) from monopolar cautery, magnetic resonance imaging (MRI), or radiofrequency ablation and therapeutic radiation. The most common and potentially life-threatening adverse effects of EMI are inhibition of cardiac pacing (leading to bradycardia or asystole) and inadvertent shocks if ICD interprets the EMI as a heart rate higher than the therapy trigger rate. Most experts recommend that a plan for device management for surgery be made by a qualified individual with the recommendation based on knowledge of the proposed surgery and the information gleaned from a recent interrogation of the device.
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References
Crossley GH, Poole JE, Rozner MA, Asirvatham SJ, Cheng A, Chung MK, Ferguson Jr TB, Gallagher JD, Gold MR, Hoyt RH, Irefin S, Kusumoto FM, Moorman LP, Thompson A. The Heart Rhythm Society Expert Consensus Statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management. Heart Rhythm. 2011;8:1114.
Allen M. Pacemakers and implantable cardioverter defibrillators. Anaesthesia. 2006;61:883–90.
Moses HW, Mullin JC. A practical guide to cardiac pacing. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007. ISBN 978-0-7817-8881-6.
Bernstein AD, Daubert JC, Fletcher RD, et al. The revised NASPE/BPEG generic code for antibradycardia, adaptive-rate, and multisite pacing. Pacing Clin Electrophysiol. 2002;25:260–4.
Leung S-K, Lau C-P. Developments in sensor-driven pacing. Cardiol Clin. 2000;18:113–55.
ASA task force on perioperative management of patients with cardiac implantable electronic devices. Practice advisory for the perioperative management of patients with cardiac implantable electronic devices: pacemakers and implantable cardioverter-defibrillators. Anesthesiology. 2011;114:247–61.
Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. J Am Coll Cardiol. 2014. doi: 10.1016/j.jacc.2014.07.944.
Schulman PM, Rozner MA. Use caution when applying magnets to pacemakers or defibrillators for surgery. Anesth Analg. 2013;117:422–7.
Rooke GA, Bowdle TA. Perioperative management of pacemakers and implantable cardioverter defibrillators: It’s not just about the magnet (editorial). Anesth Analg. 2013;117:292–4.
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Rooke, G.A. (2015). Implantable Cardiac Electronic Devices. In: Jackson, M.B., Mookherjee, S., Hamlin, N.P. (eds) The Perioperative Medicine Consult Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-09366-6_12
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DOI: https://doi.org/10.1007/978-3-319-09366-6_12
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