Related Experiment Video
Updated: May 15, 2026
07:49
A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
Published on: July 21, 2023
A perioperative management algorithm for cardiac rhythm management devices: the PACED-OP protocol
William J Mahlow1, Robert M Craft, Nicholas L Misulia
1Department of Cardiology, University of Tennessee, Knoxville, Tennessee 37920, USA. wjmmd@me.com
Pacing and Clinical Electrophysiology : PACE
|December 21, 2012
Summary
Implementing the PACED-OP protocol significantly reduced cardiac rhythm management device reprogramming during surgery. This standardized approach did not increase device-related complications, improving patient safety during electrocautery use.
Area of Science:
- Cardiology
- Anesthesiology
- Biomedical Engineering
Background:
- Limited data exists on managing cardiac rhythm management devices (CRMDs) during intraoperative electromagnetic interference.
- Standardized protocols are needed to mitigate risks associated with electrocautery in patients with CRMDs.
Purpose of the Study:
- To evaluate the effectiveness of the Pacing And Cardioverting Electronic Devices peri-Operative Protocol (PACED-OP) in reducing CRMD reprogramming.
- To assess if the PACED-OP protocol impacts CRMD-related complications during surgery.
Main Methods:
- Retrospective analysis of 497 surgical procedures involving patients with CRMDs.
- Comparison of cases before and after implementation of the PACED-OP protocol.
- Screening for intraoperative CRMD malfunction and postoperative complications linked to electrocautery.
Main Results:
- The PACED-OP protocol significantly reduced the odds of device reprogramming (aOR 0.19, P < 0.001).
- No direct evidence of CRMD malfunction was found in either cohort.
- Postoperative complication rates did not differ significantly between the pre- and post-protocol groups (aOR = 1.37, P = 0.49).
Conclusions:
- The PACED-OP protocol effectively minimizes CRMD reprogramming during surgery.
- Implementing the PACED-OP protocol is safe, with no increase in CRMD-related complications.
Related Concept Videos
01:25Dysrhythmias VI: Management of Dysrhythmias
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:30Pulse rhythm
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
01:25Dysrhythmias VII: Nursing Management of Dysrhythmias
Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
01:26Cardiac Catheterization IV: Nursing Management
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...