Monitored Anesthesia Care for Subcutaneous Cardioverter-Defibrillator Implantation: A Single-Center Experience

Area of Science:

• Cardiology
• Anesthesiology
• Medical Devices

Background:

• General anesthesia is typically preferred for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation.
• Monitored anesthesia care (MAC) is increasingly explored as an alternative approach.

Purpose of the Study:

• To evaluate the efficacy and safety of MAC for S-ICD implantation.
• To assess adequate sedation, analgesia, and perioperative hemodynamic stability during S-ICD procedures.

Main Methods:

• Retrospective analysis of prospectively collected data from S-ICD implantations using MAC.
• Efficacy endpoints included optimal sedation/analgesia and absence of severe post-procedure pain.
• Safety endpoints monitored for hypotension, bradycardia, and airway compromise.

Main Results:

• S-ICD implantation with MAC was successful in all ten patients without major adverse events.
• No patient experienced airway compromise; post-procedure pain was mild.
• Hemodynamic parameters (MAP, HR) showed minimal significant changes during the procedure.

Conclusions:

• Monitored anesthesia care (MAC) is an effective, feasible, and safe anesthetic option for S-ICD implantation and defibrillation threshold (DFT) testing.
• MAC can be utilized in patients undergoing S-ICD procedures, offering a viable alternative to general anesthesia.