Learning Cardiology

Q. Which of the following is not true regarding perioperative management of a patient with implanted intracardiac device undergoing non-cardiac surgery? A. Pacemaker should be reprogrammed to asynchronous mode (VOO mode) B. Tachyarrhythmic therapy should be terminated in ICD C. Routine preoperative and postoperative interrogation of the device is not required D. Bipolar electrocautery should be preferably used Answer: C.   Routine preoperative and postoperative interrogation of the device is not required Explanation:  Patients with Implantable cardioverter defibrillators (ICD) and pacemakers undergoing surgery: Electrocautery may interfere with devices, leading to: Device reset to default mode (Power on Reset events) which can cause asynchronous to inhibited pacing and it may be life threatening to the patient if he is pacemaker dependent Inhibition of pacemaker output False sensing with increased pacemaker rate ICD firing Myocardial injury with

Q. For the patients with implanted cardiac devices undergoing non-cardiac surgery, which of the following is not correct? A. Electrocautery may reset device to default mode B. May cause inhibition of pacemaker output C. Inappropriate ICD firing D. Power on reset events do not pose any threat to the patient Answer:  D. Power on reset events do not pose any threat to the patient Explanation:  Implantable cardiac devices