Anesthesia for subcutaneous implantable cardioverter‐defibrillator implantation: Perspectives from the clinical experience of a U.S. panel of physicians

Essandoh, Michael; Mark, George E.; Aasbo, Johan D.; Joyner, Charles A.; Sharma, Saumya; Decena, Beningo F; Bolin, Eric D.; Weiss, Raul; Burke, Martin C.; McClernon, Timothy R.; Daoud, Emile G.; Gold, Michael R.

doi:10.1111/pace.13364

Cited by 41 publications

(25 citation statements)

References 51 publications

(131 reference statements)

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“…All S‐ICD implantations were performed under the guidance of a cardiovascular anesthesiologist according to the institutional protocol . The anesthesiology team after consultation with the implanting electrophysiologist dictated the mode of anesthesia (MAC vs GA).…”

Section: Methodsmentioning

confidence: 99%

“…All S-ICD implantations were performed under the guidance of a cardiovascular anesthesiologist according to the institutional protocol. 6 The anesthesiology team after consultation with the implanting electrophysiologist dictated the mode of anesthesia (MAC vs GA). During early experience, all devices were implanted with GA; however, as the operators and anesthesiologists became familiarized with different aspects of the procedure, majority of the procedures are performed with MAC.…”

Section: Preprocedures Anesthesia Carementioning

confidence: 99%

“…Initial studies have advocated the use of general anesthesia (GA) during S‐ICD implantation as the procedures tended to be longer, required extensive dissection at the lateral pocket, and involved tunneling of the electrode and defibrillation (DF) testing . With more experience with S‐ICD implantation, monitored anesthesia care (MAC) has been proposed as a preferred approach for sedation and analgesia during these procedures …”

Section: Introductionmentioning

confidence: 99%

“…1,[3][4][5] With more experience with S-ICD implantation, monitored anesthesia care (MAC) has been proposed as a preferred approach for sedation and analgesia during these procedures. 6,7 Preference of GA during S-ICD implantation in earlier studies was due to the provision of adequate anesthesia during extensive dissection at the lateral pocket, tunneling of the electrode, and DF testing.…”

Section: Introductionmentioning

confidence: 99%

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Implantation of subcutaneous defibrillator is feasible and safe with monitored anesthesia care

Afzal

Okabe

Koppert³

et al. 2019

Pacing Clinical Electrophis

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Background The perioperative anesthesia care during subcutaneous implantable cardioverter‐defibrillator (S‐ICD) implantation is still evolving. Objective To assess the feasibility and safety of S‐ICD implantation with monitored anesthesia care (MAC) versus general anesthesia (GA) in a tertiary care center. Methods This is a single‐center retrospective study of patients undergoing S‐ICD implantation between October 2012 and May 2019. Patients were categorized into MAC and GA group based on the mode of anesthesia. Procedural success without escalation to GA was the primary endpoint of the study, whereas intraprocedural hemodynamics, need of pharmacological support for hypotension and bradycardia, length of the procedure, stay in the post‐anesthesia care unit, and postoperative pain were assessed as secondary endpoints. Results The study comprises 287 patients with MAC in 111 and GA in 176 patients. Compared to MAC, patients in GA group were younger and had a higher body mass index. All patients had successful S‐ICD implantation. Only one patient (0.9%) in the MAC group was converted to GA. Despite a similar baseline heart rate (HR) and mean arterial blood pressure (MAP) in both groups, patients with GA had significantly lower HR and MAP during the procedure and more frequently required pharmacological hemodynamic support. Length of the procedure, stay in the postanesthesia care unit, and postoperative pain was similar in both groups. Conclusion This retrospective experience suggests that implantation of S‐ICD is feasible and safe with MAC. Use of GA is associated with more frequent administration of hemodynamic drugs during S‐ICD implantation.

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Section: Methodsmentioning

confidence: 99%

Section: Preprocedures Anesthesia Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Implantation of subcutaneous defibrillator is feasible and safe with monitored anesthesia care

Afzal

Okabe

Koppert³

et al. 2019

Pacing Clinical Electrophis

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show abstract

“…In this issue of Pacing and Clinical Electrophysiology , Essandoh et al. provide a comprehensive consensus‐driven document describing various anesthesia options for implantation …”

mentioning

confidence: 99%