Comparison of perioperative strategies in ICD patients: The perioperative ICD management study (PIM study).
Pacing Clin Electrophysiol
; 41(11): 1536-1542, 2018 11.
Article
em En
| MEDLINE
| ID: mdl-30264871
ABSTRACT
BACKGROUND:
The prevalence of patients with implanted cardioverter defibrillators (ICDs) and the frequency of surgery on these patients are steadily on the rise. Guidelines recommend preoperative ICD reprogramming, although this is sometimes difficult in clinical practice. Placing a magnet on the ICD is a practical alternative and even no inactivation is possible in selected cases.METHODS:
In this prospective observational study, we compared different perioperative ICD management strategies depending on the location of the surgery and the type of electrocautery used. Patients undergoing surgery above the umbilicus with monopolar electrocautery had their ICD therapy inactivated by reprogramming. When surgery below the navel or surgery above the navel with bipolar electrocautery was completed, ICD inactivation was performed using a magnet. No inactivation was performed on patients undergoing lower extremity surgery with bipolar electrocautery. Only ICD patients who were not pacemaker dependent were enrolled. After surgery, the ICDs were assessed regarding documented arrhythmias and parameters.RESULTS:
Out of 101 patients included in this study, the ICD was preoperatively reprogrammed in 42 patients (41.6%), a magnet was used on 45 patients (44.5%), and ICDs were not deactivated at all in 14 patients (13.9%). No intraoperative electromagnetic interference was detected. Postoperative ICD analysis demonstrated no changes of preset parameters.CONCLUSIONS:
All three tested ICD management strategies were proved safe in this study. Keeping the location of surgery and the type of electrocautery in mind, an intraoperative magnet or even no ICD deactivation at all could be feasible alternatives in surgery on patients with ICDs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Desfibriladores Implantáveis
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Assistência Perioperatória
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Magnetismo
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
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Female
/
Humans
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Male
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Alemanha