What are the key actions in perioperative management of permanent pacemakers (PPMs) and automatic implantable cardioverter-defibrillators (AICDs)?

Updated: Oct 29, 2018
  • Author: Albert H Tsai, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Answer

Answer

Key action points in the perioperative management of permanent pacemakers (PPMs) and automatic implantable cardioverter-defibrillators (AICDs) include the following:

  • Understand the indication for which the patient requires a cardiac implantable electronic device (CIED)
  • If the patient already has a device in place, determine whether he or she is pacer-dependent 
  • Determine the type of CIED, the mode in use, and the integrity of the device
  • Assess the potential for intraoperative electromagnetic interference (EMI)
  • Understand when it is appropriate to use a magnet, to interrogate, or to reprogram the device
  • Ensure that alternative methods of pacing and defibrillating are available perioperatively
  • Understand perioperative factors that may affect PPM/AICD function

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