Why the study?
As the population ages, the need for anesthesiologists to manage complicated implantable cardioverter defibrillators (ICDs) has increased.
In patients with ICDs undergoing procedures, external defibrillator pads should be placed preoperatively to manage hemodynamically unstable tachyarrhythmias due to potential ICD pseudomalfunction.
Emphasizes external defibrillator pad readiness in ICD patients undergoing TAVR; case report leaves open magnet reliability in procedural VT.
As the population ages, the need for anesthesiologists to manage complicated implantable cardioverter defibrillators (ICDs) has increased. We present a case of hemodynamically unstable ventricular tachycardia occurring during a transcatheter aortic valve replacement where magnet removal from the ICD did not result in the expected tachytherapies. When managing patients with an ICD, we emphasize preoperative placement of external defibrillator pads and prompt use of external shocks rather than relying on the ICD to manage hemodynamically unstable tachyarrhythmias.
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Nelson et al. (2025) studied this question.
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