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Transcript
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
