Expert Consensus Statement: Perioperative Management of Patients with CIEDs

Experts present the first set of recommendations on management of patients with implanted cardiac devices during and after surgical or medical procedures

SAN FRANCISCO — The Heart Rhythm Society (HRS) issues the first consensus statement for the perioperative management of patients with cardiovascular implantable electronic devices (CIEDs). The HRS Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors: Facilities and Patient Management was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA) and the Society of Thoracic Surgeons (STS). The HRS expert consensus statement was presented today at Heart Rhythm 2011, the Society’s 32nd Annual Scientific Sessions.

The perioperative period for patients with pacemakers and defibrillators poses unique challenges in assuring a high degree of patient safety. There are factors such as rapid changes in CIED technology, expanded use of potential sources of electromagnetic interference (EMI) and out-dated recommendations based upon limited data that highlight the need for a consensus statement. The HRS expert consensus statement is the first to offer clinicians and industry guidance on the management of CIEDs during and after surgical or medical procedures.

“With the increasing number of cardiac devices being implanted around the world, it’s crucial that recommendations are frequently reviewed, updated and shared to ensure optimal patient care,” stated co-lead author of the statement, George Crossley, MD, FHRS, at St. Thomas Research Institute and University of Tennessee College of Medicine in Nashville, Tenn. “While the ultimate judgment of care must be made by the individual patient and his or her health care provider, this document aims to provide clinicians with the best possible guidance available.”

HRS and ASA brought together a diverse panel of experts in pacemaker and defibrillator management to focus on medical procedures that might interfere with CIED function. To address the topic, a multidisciplinary group convened, including cardiac electrophysiologists, anesthesiologists, a cardiothoracic surgeon and an allied health professional. 

The statement provides the following:

  • Evaluation of the potential problems that can occur in patients with CIEDs within the perioperative setting;
  • Recommendations for the appropriate preoperative evaluation of patients with a CIED;
  • Management of the CIED during the surgical or medical procedure;
  • Postoperative care of the patient with a CIED who has undergone certain surgical or medical procedures.

Furthermore, a primary recommendation from the expert consensus writing committee is that the patient’s CIED team, or another available CIED team, provides the operative team with guidance on the perioperative management of the CIED. According to the expert panel, the best possible outcome will result when advice from the patient’s CIED team is effectively communicated to the procedural team, and executed during the patient’s perioperative care.

“The collaborative nature of the writing committee allowed clinicians and professionals of varied medical backgrounds to discuss and evaluate the complexity of CIED patient management,” stated co-lead author of the statement, Jeanne Poole, MD, University of Washington in Seattle. “The combined experience of the experts and the results of this document provide a unique, first-of-its-kind consensus on the perioperative care of these patients.”

The expert consensus statement will be published in the June edition of HeartRhythm, the official journal of the Heart Rhythm Society.

Sessions details:
“Final Recommendations and Guidance on Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors” [May 5, 2011, 8:00 a.m. – 9:30 a.m., Room 134 Moscone North]

About Heart Rhythm 2011
Heart Rhythm 2011 takes place May 4-7, 2011 at the Moscone Center in San Francisco, CA. The Society’s Annual Scientific Sessions is the most comprehensive educational event on heart rhythm disorders, offering more than 250 educational opportunities in multiple formats. The world’s most renowned scientists and physicians will present a wide range of heart rhythm topics including cardiac resynchronization therapy, catheter ablation, cardiac pacing and heart failure as well as the latest technology, including state-of-the-art pacemakers and defibrillators.

About the Heart Rhythm Society
The Heart Rhythm Society is the international leader in science, education and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education and optimal health care policies and standards. Incorporated in 1979 and based in Washington, DC, it has a membership of more than 5,300 heart rhythm professionals in more than 70 countries around the world.

Contact: Kennesha Baldwin
Heart Rhythm Society
(202) 464-3476
[email protected]

Cindy Rahman: (703) 283-8499
Heart Rhythm 2011 Press Room: (415) 978-3514 (this phone number active through Saturday,
May 7, 1:00 p.m. PT)