Anestéziológia a intenzívna medicína 1/2013

Perioperative management of patients with pacemaker and implantable cardioverter-defibrillator

As the number of patient with implantable pacemaker or cardioverter-defibrilator grows every year the chance meeting these patients undergoing noncardiac surgery grows at the same time. Modernisation of the devices brings the new indications and the usage of the modes, although many anaesthetists are not comfortable and skilled with perioperative management. The communication between surgeon, anaesthetist and cardiologist is needed preoperatively, however the anaesthetist must be trained for the management in case of urgent operation. This article discusses basics of current pacemakers and implantable cardioverter-defibrilators (indications, coding, modes), risks and complications during surgery and the essentials of the perioperative management. The main goal is to provide short review supported by up to date experts’ recommendations.

Keywords: perioperative management, pacemaker, cardioverter-defibrilator.