Recommendations for Perioperative Management of Patients with Cardiac Implantable Electronic Devices

Abstract

SUMMARY – Four thousand cardiac implantable electronic devices (CIED) are implanted yearly in Croatia with constant increase. General anesthesia and surgery carry some specific risk for the patients with implanted CIEDs. Since most of the surgical procedures are performed in institutions without reprogramming devices available, or in the periods when they are unavailable, these guidelines aim to standardize the protocol for perioperative management of these patients. With this protocol, most of the procedures can be performed easily and, more importantly, safely in the majority of surgical patients.

Anaesthetic Management of Major Abdominal Oncosurgery in a Patient With an Automated Implantable Cardioverter-Defibrillator (AICD): A Case Report

“…Device reprogramming before surgery is essential in patients who are vitally dependent on anti-bradycardia pacing, as the magnet does not affect anti-bradycardia function. If the AICD is reprogrammed (detection switched off) or a magnet is used to deactivate the therapeutic mode, as in our patient, then the treatment of malignant arrhythmias requires either the removal of the magnet to restore device function or the use of external defibrillation with the magnet [ 7 ].…”

Left Ventricular Lead Placement for Pacing and Sensing in a Patient with Arrhythmogenic Right Ventricular Cardiomyopathy Undergoing ICD Implantation

“…Arrhythmogenic right ventricular cardiomyopathy is a hereditary disease characterized by fibro-fatty replacement of myocardium, occurrence of ventricular arrhythmias and risk of sudden cardiac death ( 2 ). ICD implantation is indicated in selected patients ( 3 , 4 ). Achieving stable lead position with adequate sensing can be challenging.…”

Assessment and modification of cardiovascular risk in non-cardiac surgery. Clinical guidelines 2023

“…В случае применения униполярной электрокоагуляции индифферентный электрод следует размещать как можно дальше от имплантированного устройства (как правило, на поверхности бедра). Рекомендуется использовать короткие (<5 секунд) аппликации с 5-секундными перерывами между воздействиями [291,292].…”