CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bourke, M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Bourke, M.

Canadian Journal of Anesthesia, Vol 43, R24-R41, Copyright © 1996 by Canadian Anesthesiologists' Society

ARTICLES

The patient with a pacemaker or related device

ME Bourke
Department of Anaesthesia, University of Ottawa Heart Institute, Ottawa Civic Hospital, Ontario.

Patients with implanted pacemakers and ICDs can be safely managed for surgery and anaesthesia. Anaesthetic management of such patients should be planned first according to the patient's underlying medical status with particular emphasis on ventricular function and electrolyte balance. The anaesthetist must understand the various modes of pacemakers and ICDs available in the patient population. These devices are safe and well shielded form most electromagnetic interference in the operating room. Some precautions are nevertheless necessary. A magnet should not be placed routinely over a programmable pacemaker or ICD in the operating room, especially in the presence of electrocautery. Rate-responsive pacemakers should have rate adaptive modes disabled before surgery whenever possible. The mechanism of rate response should be known, so that inappropriate changes in heart rate can be avoided in the perioperative period if the rate responsive mode cannot for some reason be disabled. Antitachycardia pacemakers, should have the antitachycardia function disabled preoperatively. Methods for the provision of alternate emergency pacing should be available when dealing with patients at risk of bradyarrhythmias or pacemaker failure in the operating room. The anaesthetist should have a safe, practical plan of action that suites his/her experience and capabilities. ICDs should have automatic cardioverter-defibrillator functions disabled for surgery and external modes of cardioversion/defibrillation should be available.


This article has been cited by other articles:


Home page
 CirculationHome page
L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al.
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Circulation, October 23, 2007; 116(17): e418 - e499.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the Canadian Anesthesiologists' Society.