Journal of Research & Innovation in Anesthesia

Register      Login

VOLUME 3 , ISSUE 2 ( July-December, 2018 ) > List of Articles

CASE REPORT

Open Heart Surgery in a Patient with Dual Chamber Pacemaker

Lakshmi A Sathyanarayana

Keywords : Cardioplegia, Dual chamber pacemaker, Electrical interference, Open heart surgery, Pacemaker dependence, Reprogramming

Citation Information : Sathyanarayana LA. Open Heart Surgery in a Patient with Dual Chamber Pacemaker. Res Inno in Anesth 2018; 3 (2):66-69.

DOI: 10.5005/jp-journals-10049-0054

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

With changing cohort of cardiac patients, elderly patients with comorbidities like a patient with a pacemaker may be encountered in clinical practice. In patients with a pacemaker undergoing noncardiac surgery, electromagnetic interference can alter the function of a permanent pacemaker. Additional concerns during open heart surgery in a patient with a permanent pacemaker are lead displacement with venous cannulation, electrical activity during cardioplegia and damage to the device by defibrillation. Management of a patient with a pacemaker for a surgery calls for a multidisciplinary approach with involvement of cardiologist, electrophysiologist, device manufacturer, anesthesiologist, and cardiac surgeon. To the best of our knowledge, there are no case reports or guidelines about a patient with a pacemaker coming for cardiac surgery, and we report the perioperative management of a pacemaker dependent patient undergoing aortic valve replacement for severe aortic stenosis.


PDF Share
  1. Madigan JD, Choudhri AF, Chen J, Spotnitz HM, Oz MC, Edwards N. Surgical management of the patient with an implanted cardiac device: implications of electromagnetic interference. Annals of Surgery 1999;230(5):639.
  2. Gallagher MD, David Hayes MD, Jane EH. Practice advisory for the perioperative management of patients with cardiac implantable electronic devices: pacemakers and implantable cardioverter-defibrillators. Anesthesiology 2011;114(2):247-261.
  3. Rapsang AG, Bhattacharyya P. Pacemakers and implantable cardioverter defibrillators-general and anesthetic considerations. Revista Brasileira de Anestesiologia. 2014;64(3):205-214.
  4. Rastogi S, Goel S, Tempe DK, et al. Anaesthetic management of patients with cardiac pacemakers and defibrillators for noncardiac surgery. Annals of Cardiac Anaesthesia 2005;8(1):21-32.
  5. Senthuran S, Toff WD, Vuylsteke A, et al. Editorial III. British Journal of Anaesthesia [Internet]. Elsevier BV 2002;88(5):627-631.
  6. Andersen C, Madsen GM. Rate-responsive pacemakers and anaesthesia A consideration of possible implications. Anaesthesia. 1990;45(6):472-476.
  7. Sharma P, Singh MK, Vats A, et al. Central Venous Catheter Insertion in Patients With Transvenous Pacemaker or Defibrillator Leads. Journal of Cardiothoracic and Vascular Anesthesia 2011;25(4):e25.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.