Anesthesia teams managing pacemakers and ICDs for the perioperative period: enhanced patient safety and improved workflows

Joshua B. Feldman, Marc E. Stone

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Purpose of review There have been both technological and philosophical advances over the last decade regarding pacemakers and implanted cardioverter defibrillators (ICDs). Collectively, these devices are currently referred to as cardiac implantable electronic devices (CIEDs). Technological advances include the introduction of leadless pacemakers, subcutaneous defibrillators and cardiac event recorders, enhancements regarding compatibility of CIEDs for MRI scanning, the ability to interrogate devices remotely, and improved programming modes that preserve battery life. Philosophical advances have been mainly in the area of perioperative management of CIED patients. Recent findings Current practice recommendations now acknowledge that not every patient requires a formal interrogation of their CIED before and after surgery (as was previously recommended). The response to magnet application is standardized across manufacturer's platforms, and it is known that sources of electromagnetic interference remote from the CIED and its leads do not usually cause any interference with device function. Summary Educated anesthesia teams can independently manage the vast majority of CIED patients perioperatively with magnet application alone. Furthermore, this portends enhanced patient safety and improved workflows in the perioperative period.

Original languageEnglish
Pages (from-to)441-447
Number of pages7
JournalCurrent Opinion in Anaesthesiology
Issue number3
StatePublished - 1 Jun 2020


  • cardiac implantable electronic device
  • implantable cardioverter defibrillator
  • pacemaker
  • pacemaker magnet
  • perioperative management


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