Why the study?
Subcutaneous implantable cardioverter-defibrillators introduce unique perioperative considerations and complex management challenges when standard interrogation and suspension strategies fail.
Highlights the complexity of S-ICD management and the potential failure of magnet application to suspend antitachycardia therapy during perioperative care.
Alerts anesthesiologists to possible S-ICD magnet failure; leaves open need for updated perioperative protocols.
We present the case of a patient with a subcutaneous implantable cardioverter-defibrillator (S-ICD) in situ. Device interrogation and reprogramming were unsuccessful due to a software mismatch between the device and programmer. The device manufacturer recommended magnet application to suspend antitachycardia therapy. Despite using this strategy, the S-ICD discharged multiple times. The S-ICD has unique perioperative considerations for the anesthesiologist. This case provides an example of the complexity of electrophysiologic devices in current use and the necessity of the anesthesia provider to stay up to date with evolving device management strategies.
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McFaul et al. (2020) studied this question.
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