[Patients with implanted devices in intensive care medicine]

Area of Science:

• Cardiology
• Intensive Care Medicine
• Biomedical Engineering

Context:

• Intensive care units (ICUs) frequently manage patients with implanted cardiac electronic devices (CIEDs).
• CIEDs include pacemakers, defibrillators, cardiac contractility modulators, and event recorders.
• Effective management necessitates awareness of device specifics and potential interactions within the ICU environment.

Purpose:

• To outline essential considerations for managing ICU patients with CIEDs.
• To highlight methods for device identification and parameter assessment.
• To address challenges in invasive monitoring and external cardioversion/defibrillation.

Summary:

• Device identification via ECG, chest X-ray, and interrogation is key.
• Intracardiac electrodes complicate invasive monitoring, requiring careful venous access site selection.
• Specific protocols are needed for external cardioversion/defibrillation to prevent device damage.
• Adapting device programming to ICU conditions optimizes patient management.

Impact:

• Improved patient outcomes through tailored critical care for those with CIEDs.
• Reduced risk of complications associated with invasive procedures and external therapies.
• Enhanced collaboration between critical care physicians and device specialists.
• Guidance for healthcare professionals on navigating complex device management in critical care settings.