Which electrolyte and metabolic abnormalities can adversely affect 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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Although EMI is the major source of intraoperative alterations in CIED function, there are a number of additional factors that may also influence the operation of a CIED within the perioperative period. [8, 9]

The electrolyte and metabolic abnormalities frequently observed in the perioperative period can adversely affect CIED function and should therefore be aggressively corrected. Specifically, hyperkalemia, hyperglycemia, alkalemia, acidemia, hypoxemia, and hypercapnia increase the pacing threshold and may lead to failure to capture. Additionally, hypokalemia and hypomagnesemia may lead to hemodynamically significant arrhythmias

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