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Intravenous sedation for placement of automatic implantable cardioverter-defibrillators
M L Pinosky1, S T Reeves, R L Fishman
1Department of Anesthesiology, Medical University of South Carolina, Charleston 29425-2207, USA.
Objective:
To evaluate a change in anesthetic technique for transvenous placement of the automatic implantable cardioverter-defibrillator (ICD).
Design:
Retrospective study.
Setting:
A university hospital.
Participants:
Twenty-eight patients who underwent placement of ICDs.
Interventions:
Thirteen patients had the ICD placed via the transvenous approach with general anesthesia (group GA). Fifteen patients had the ICD placed via the transvenous approach with intravenous sedation (group IV).
Measurements And Main Results:
Intraoperative systolic and diastolic blood pressures were significantly higher in group IV compared with group GA. The ICD was successfully placed in all patients in both groups. There were no intraoperative complications noted in either group during induction of fibrillation and defibrillation, and there was no recall by any patient in either group. The average hospital stay was significantly less in group IV (1.8 days) compared with group GA (3.4 days).
Conclusions:
Intravenous sedation for the placement of ICDs is a safe and effective technique. Patients who had their ICD placed while receiving intravenous sedation experienced higher intraoperative blood pressures and were discharged from the hospital earlier than those patients who received general anesthesia.