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British Journal of Anaesthesia, 2002, Vol. 88, No. 5 627-631
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial

Editorial III

Implanted cardiac pacemakers and defibrillators in anaesthetic practice

S. Senthuran1, W. D. Toff2, A. Vuylsteke3, P. M. Solesbury4 and D. K. Menon5

1University Department of Anaesthesia, University of Cambridge, Box 93, Addenbrooke’s Hospital, Cambridge CB2 2QQ, UK 2Division of Cardiology, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester LE3 9QP, UK 3Papworth Hospital NHS Trust, Cambridge University Teaching Hospitals Trust, Cambridge CB3 8RE, UK 4Device Technology & Safety Group, Medical Devices Agency, UK Department of Health, Mail Point 10/S/10, Hannibal House, Elephant & Castle, London SE1 6TQ, UK 5University of Cambridge, Box 93, Addenbrooke’s Hospital, Cambridge CB2 2QQ, UK

There are almost 200 000 patients with implanted pacemakers and over 4000 patients with implanted cardioverter defibrillators (ICD) in the UK. The corresponding annual rates of new implants are approximately 18 000 and 1000 (A. D. Cunningham, personal communication) and ICD use is likely to increase significantly with the recent publication of guidance from the National Institute for Clinical Excellence (NICE), which recommends a threefold increase in the implant rate.1 It is increasingly likely that physicians in specialities other than cardiology, such as anaesthetics and accident and emergency medicine, may encounter patients with implanted devices, yet the experience of individual clinicians of device-related problems is likely to remain limited. Increased diversity and technological complexity of the devices and the emergence of new indications for their use offer ever more scope for incomplete understanding that may lead to mishaps.

New technology: modern pacemakers and ICDs

Current pacing systems include single-chamber devices for atrial or ventricular pacing and dual-chamber devices, . . . [Full Text of this Article]

Relevance to the anaesthetist

Preoperative assessment

Perioperative problems

How frequent are problems during the perioperative period?

The way forward

References


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