• Curr Opin Anaesthesiol · Jun 2020

    Review

    Anesthesia teams managing pacemakers and ICDs for the perioperative period: enhanced patient safety and improved workflows.

    • Joshua B Feldman and Marc E Stone.
    • Department of Anesthesiology, Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai New York, New York, USA.
    • Curr Opin Anaesthesiol. 2020 Jun 1; 33 (3): 441-447.

    Purpose Of ReviewThere have been both technological and philosophical advances over the last decade regarding pacemakers and implanted cardioverter defibrillators (ICDs). Collectively, these devices are currently referred to as cardiac implantable electronic devices (CIEDs). Technological advances include the introduction of leadless pacemakers, subcutaneous defibrillators and cardiac event recorders, enhancements regarding compatibility of CIEDs for MRI scanning, the ability to interrogate devices remotely, and improved programming modes that preserve battery life. Philosophical advances have been mainly in the area of perioperative management of CIED patients.Recent FindingsCurrent practice recommendations now acknowledge that not every patient requires a formal interrogation of their CIED before and after surgery (as was previously recommended). The response to magnet application is standardized across manufacturer's platforms, and it is known that sources of electromagnetic interference remote from the CIED and its leads do not usually cause any interference with device function.SummaryEducated anesthesia teams can independently manage the vast majority of CIED patients perioperatively with magnet application alone. Furthermore, this portends enhanced patient safety and improved workflows in the perioperative period.

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