Implantable cardioverter-defibrillators

In the quest to save lives, a greater number of ICDs are implanted each year. These ICDs with pacing capabilities offer a successful therapeutic intervention to a devastating problem. Patients who have these devices will appear in operating rooms around the country. Manage these patients like all other patients who have heart disease, before turning attention to the ICD. Programming the device to “off” should suffice in protecting patients from ill-timed defibrillatory shocks. Placing the magnet over the generator and holding it in that location also will inhibit the ICD. Use external pads to defibrillate patients who experience intraoperative ventricular arrhythmias. Interrogate and reprogram the ICD immediately after surgery. As expected, it is not anesthesia, per se, that harms the patient. It is the underlying heart disease.