From the Research
Pre-operative management of patients with implantable cardioverter-defibrillators (ICDs) should prioritize a multifaceted approach, including the use of beta-blockers, prognostic heart failure medications, antiarrhythmic drugs, ICD reprogramming, ablation, ICD upgrade/revision, and coronary revascularisation, as this has been shown to reduce the risk of subsequent ICD therapy 1.
Key Considerations
- The management of patients with ICDs requires a comprehensive approach, taking into account the type of surgery, location, and electrocautery used 2.
- ICD reprogramming, magnet use, or no deactivation at all may be feasible alternatives in surgery on patients with ICDs, depending on the specific situation 2.
- The use of a multifaceted approach, including medication and device management, can reduce the risk of subsequent ICD therapy and improve patient outcomes 1.
Perioperative Management
- Anesthesia practitioners should familiarize themselves with the response to magnets application on ICD function and understand the situations in which magnet use is not advisable 3.
- Perioperative communication with the patient's cardiologist and surgeon is critical in reducing adverse outcomes 3.
- The location of surgery and the type of electrocautery used should be taken into account when determining the best approach for ICD management 2.