Perioperative Management of Cardiac Implantable Electronic Devices: A Single-Center Report of 469 Interrogations

Abstract

Objective: Anesthesiologists increasingly are involved in the perioperative management of cardiac implantable electronic devices (CIEDs). The variety of devices available and the ongoing advancements in technology, programming capabilities, and responses to conventional management (eg, magnet application) complicate the management of these devices. As an aid to this clinical challenge, this manuscript reviews 469 interrogations performed by a single cardiac anesthesiologist during a 4.5-year period to derive useful information with which to guide anesthesiologists who have chosen to pursue training in this area of perioperative care.

Design: Retrospective review of prospectively collected data.

Setting: Single institution, quaternary care hospital.

Participants: Patients with CIEDs presenting for surgery; the quality assurance (QA) reports of 469 interrogations performed between May 2015 and September 2019 were reviewed.

Interventions: No intervention.

Measurement and main results: The distributions of surgical procedures, device types, device manufacturers, pacing modes, rate-response sensors, special functions, and performed interventions were reviewed and analyzed. The QA reports were evaluated to identify information or experiences that demonstrated important lessons for anesthesiologists engaging in perioperative CIED management.

Conclusions: This database review provides general guidance for anesthesiologists managing CIEDs in the perioperative period. Concepts germane to the operating room are emphasized.

Keywords: CIED; ICD; cardiac implantable electronic devices; implantable cardioverter-defibrillator; pacemakers; perioperative CIED management; perioperative ICD service.