Anesthetic management of patients with cardiac implantable electronic devices undergoing non-cardiac surgeries

Abstract

SUMMARY C ardiovascular implantable electronic device (CIED) is a term that encompasses pacemakers for bradyarrhythmia treatment, implantable cardioverter defibrillators (ICDs) for tachyarrhythmia management, and cardiac resynchronization therapy (CRT) devices for systolic dysfunction with conduction delays. Many anaesthesia practitioners caring for patients with a cardiac implantable electronic device (CIED) lack the knowledge, experience, and requisite programming devices to independently manage these patients perioperatively. A pacemaker is an electronic device that senses intrinsic cardiac electric potentials and, if these are too infrequent or absent, transmit electrical impulses to the heart to stimulate myocardial contraction. A specialized type of pacemaker therapy is cardiac resynchronization therapy (CRT) with biventricular pacing. Cardiac resynchronization therapy (CRT), also referred to as biventricular pacing or multisite ventricular pacing, is a component of modern heart failure therapy for qualified patients. CRT can involve either pacing (CRT-P) or defibrillation (CRT-D).