Key result
Surgery in a dual-chamber ICD patient triggers intraoperative pacemaker-mediated tachycardia unresponsive to magnet application.
Why the study?
Patients with cardiac implantable electronic devices are at additional risk for arrhythmias during surgical procedures, and management of pacemaker-mediated tachycardia in this setting is challenging.
Case Report (n=1)
Standard application of a magnet does not affect the pacing functions of an implantable cardioverter-defibrillator, requiring timely coordination with the cardiac electrophysiology team to manage intraoperative pacemaker-mediated tachycardia.
Answers are grounded in this paper and cite their sources.
Magnet application may fail to terminate intraoperative pacemaker-mediated tachycardia in dual-chamber ICDs; this case leaves open optimal perioperative device protocols.
Patients with cardiac implantable electronic devices are at additional risk for arrhythmias while undergoing surgical procedures. In this case report, we present a patient with a dual chamber implantable cardioverter-defibrillator who developed intraoperative pacemaker-mediated tachycardia causing significant hemodynamic instability. Management of this arrhythmia can be particularly challenging, because standard application of a magnet does not affect the pacing functions of an implantable cardioverter-defibrillator. Awareness by the anesthesiologist and timely coordination with the cardiac electrophysiology team helped to optimize care for this patient.
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Izrailtyan et al. (2012) conducted a case report in Intraoperative pacemaker-mediated tachycardia (n=1). Surgical procedure with a dual chamber implantable cardioverter-defibrillator was evaluated. Surgical procedures in a patient with a dual chamber ICD led to intraoperative pacemaker-mediated tachycardia and hemodynamic instability, which was unresponsive to standard magnet application.
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