Updated June 30, 2011
The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors: Facilities and Patient Management
This document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS)
The purpose of this document is to provide an expert consensus on the management of patients with cardiovascular implantable electronic devices (CIEDs) during and after surgical or medical procedures. Each of the authors is an expert in the management of CIEDs in the setting of medical procedures that might interfere with their function, and the statement represents the consensus of the writing committee based on a review of the literature, their own experience in treating patients, and input from a reference group.
In generating its consensus, the committee reviewed a large body of literature that consists mainly of case reports and small series of cases. There are no randomized controlled trials and very few case series to rely upon; therefore, many of the recommendations are based upon the extensive experience of the writing group. Consequently, there has been no assignment of levels of evidence.
The Heart Rhythm Society Expert Consensus Statement on the perioperative management of patients with implantabledefibrillators, pacemakers and arrhythmia monitors: Facilities and patient management provides the following:
- Evaluation of the potential problems that can occur in patients with CIEDs within the perioperative setting
- Recommendations for the appropriate preoperative evaluation of patients with a CIED
- Management of the CIED during the surgical or medical procedure
- Postoperative care of the patient with a CIED who has undergone certain surgical or medical procedures
“With the increasing number of cardiac devices being implanted around the world, it’s crucial that recommendations are frequently reviewed, updated and shared to ensure optimal patient care,” stated co-lead author of the statement, George Crossley, MD, FHRS, at St. Thomas Research Institute and University of Tennessee College of Medicine in Nashville, Tenn. “While the ultimate judgment of care must be made by the individual patient and his or her health care provider, this document aims to provide clinicians with the best possible guidance available.”
The expert consensus statement will be published in the July edition of HeartRhythm, the official journal of the Heart Rhythm Society.
Read the Heart Rhythm Society press release on the creation and publication of this document.
