What question did this study set out to answer?

To assess the cardiopulmonary and hemodynamic changes induced by electrophysiological testing during internal cardioverter/defibrillator (ICD) implantation under general anesthesia.

October 1, 1991Acta Anaesthesiologica Scandinavica

Cardiopulmonary effects of internal cardioverter/defibrillator implantation

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Why the study?

Does electrophysiological testing of ICD devices impair cardiopulmonary function in patients with impaired left ventricular function?

Population

10 patients with impaired left ventricular function undergoing general anaesthesia for internal…

Comparison

Electrophysiological testing of internal… vs Control-phase.

Design

Case_series

Follow-up

Acute (during the procedure)

Authors

THT. HachenberoUniversity of Münster DHDieter HammelKlinikum Links der Weser TMT. MöllhoffParsons Brinckerhoff

Discussion

Member takes

Implication

May warrant heightened monitoring during ICD testing in LV impairment; hypothesis-generating and should not yet change practice.

Key Points

To assess the cardiopulmonary and hemodynamic changes induced by electrophysiological testing during internal cardioverter/defibrillator (ICD) implantation under general anesthesia.
Evaluated 10 patients undergoing general anesthesia for ICD implantation and electrophysiological testing.
Measured hemodynamic variables, pulmonary gas exchange, venous admixture, and alveolo-arterial PO2 difference before and after electrophysiological procedures.
Cardiac index decreased by 16%, while left ventricular filling pressure and pulmonary vascular resistance significantly increased (P <= 0.01).
Venous admixture increased by 72% and alveolo-arterial PO2 difference increased by 43% (P <= 0.01), reflecting ventilation-perfusion mismatching.
Acute congestive heart failure secondary to transient global myocardial ischemia required positive inotropic intervention in 40% of patients.

Structured PICO

Does electrophysiological testing of ICD devices impair cardiopulmonary function in patients with impaired left ventricular function?

Population

10 patients with impaired left ventricular function undergoing general anaesthesia for internal cardioverter/defibrillator (ICD) implantation.

Intervention

Electrophysiological testing of internal cardioverter/defibrillator (ICD) devices, including repeated inductions of ventricular tachycardia and/or fibrillation.

Comparator

Control-phase (baseline prior to completion of the electrophysiological procedures).

Outcome

Changes in cardiopulmonary function (haemodynamic performance and oxygenation).surrogate

Electrophysiological testing during ICD implantation causes significant acute deterioration in haemodynamics and gas exchange in patients with impaired left ventricular function.

Cite This Study

Hachenbero et al. (1991) studied this question.

synapsesocial.com/papers/6a7ea742d14c4cd8047983e3 https://doi.org/10.1111/j.1399-6576.1991.tb03361.x

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Cardiopulmonary effects of internal cardioverter/defibrillator implantation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Cardiopulmonary effects of internal cardioverter/defibrillator implantation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Also Consider