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Initial Experience of an Anesthesiology-based Service for Perioperative Management of Pacemakers and Implantable

G Alec Rooke1, Stefan A Lombaard, Gail A Van Norman

  • 1From the Department of Anesthesiology and Pain Medicine (G.A.R., S.A.L., G.A.V.N., J.D., K.M.N.) and Division of Cardiology, Department of Medicine (L.W.L., J.E.P.), University of Washington, Seattle, Washington.

Anesthesiology
|September 10, 2015
PubMed

Insights

Anesthesiologists can safely manage cardiovascular implantable electronic devices (CIEDs) during surgery, reducing reliance on cardiology services. Specialized training and collaboration are key for successful CIED management in surgical settings.

Area of Science:

  • Anesthesiology
  • Cardiology
  • Biomedical Engineering

Background:

  • Managing cardiovascular implantable electronic devices (CIEDs) for surgery presents challenges due to increasing patient numbers and limited provider expertise.
  • A specialized anesthesiology device service (ADS) was established to manage CIEDs, including pacemakers and implantable cardioverter defibrillators, for surgical procedures.

Purpose of the Study:

  • To evaluate the safety and efficacy of an anesthesiology-led device service for managing CIEDs during surgery.
  • To compare the workload and outcomes of CIED management by the Anesthesiology Device Service (ADS) versus the Electrophysiology/Cardiology Service (EPCS).

Main Methods:

  • Retrospective chart review of patients undergoing surgery between October 2009 and June 2013.
  • Analysis of device management by EPCS, ADS, and neither service.
  • Assessment of workload changes, surgical delays, and programming errors.

Main Results:

  • The ADS managed a higher volume of CIEDs (548) compared to the EPCS (254).
  • The ADS demonstrated increasing independence with decreasing EPCS supervision, requiring minimal assistance.
  • No patient harm resulted from CIED management by either service, despite programming challenges.

Conclusions:

  • An anesthesiology device service can safely manage CIEDs for surgical procedures.
  • Specialized provider training and robust collaboration with the EPCS are essential for ADS success.
  • An ADS is most feasible in high-volume surgical settings due to CIED management complexity.
Abstract

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