[Patients with implanted devices in intensive care medicine]

The management of intensive care patients with implanted devices requires the knowledge of the type of device (e.g. pacemaker, defibrillator, device for cardiac contractility modulation or event recorder). An electrocardiogram (ECG) and chest-X-ray can be helpful for identification of the type and manufacturer of the device. Information concerning the programmed parameters can be obtained by device interrogation. The establishment of invasive monitoring can be complicated by the intracardiac electrodes of the devices and requires a careful selection of the venous access site. In cases of external cardioversion/defibrillation there are some specific considerations to be made to avoid damage of the implanted device. Finally, adaption of device programming to the special circumstances in the intensive care unit may help patient and physician.