Perioperative management of patients with cardiac implantable electronic devices

Abstract

The use of cardiac implantable electronic devices (CIEDs) is ever increasing in an ageing population, and an increasing number of patients with these devices are encountered by perioperative healthcare providers when they present for surgery. Electromagnetic interference remains one of the most important risks to the safe functioning of CIEDs.

This article explores the strategies for managing various CIEDs including leadless devices in the perioperative setting, highlighting the importance of thorough preoperative evaluation, appropriate reprogramming of devices or magnet placements, continuous intraoperative monitoring, management of intraoperative complications and postoperative assessment. Close multidisciplinary collaboration between anaesthesiologists and cardiologists that form the CIED team remain essential in ensuring patient safety and preventing adverse outcomes.