Download Perioperative Considerations of Pacemakers

Perioperative Considerations of Pacemakers
Special ED Electricity in the OR
Electrical Isolation is designed
to make it more difficult to burn
or electrocute in the OR
How does a pacemaker detect intrinsic rhythms and pace?
Sensitivity – the voltage level tham must be exceeded to detect an R wave or P wave.
Threshold – the minimum current needed to pace the atrium/ventricle
Magnet
Pacemaker – magnet will frequently put the device in DOO at 99.
ICD – magent will frequently shut off the defibrillation functions
Modes
Pre-operative & Post-operative Decisions
PM (Non-PM dependent) – Consider leaving PM at original settings
PM (PM dependent) – Consider leaving PM at original settings if OR current unlikely to cross PM
paths (intracardiac path if bipolar PM, left chest to heart path if unipolar PM) vs. use asynchronous
mode during OR and revert back to original mode after OR
ICD - Consider leaving ICD alone if OR current unlikely to cross ICD paths vs. turn off ICD for the
case with defibrillator pads available & have the ICD interrogated to make sure it functions afterward