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Cardiac pacemakers and anesthesia

Ryan J Kline, Ky Pham, Carmen L Labrie-Brown, Ken Mancuso, Paul LeLorier, James Riopelle, Alan David Kaye
BACKGROUND: Reflex hypotension and bradycardia have been reported to occur following administration of several drugs associated with administration of anesthesia and also following a variety of procedural stimuli. CASE REPORT: A 54-year-old postmenopausal female with a history of asystole associated with sedated upper gastrointestinal endoscopy and post-anesthetic-induction tracheal intubation received advanced cardiac resuscitation after insertion of a temporary transvenous pacemaker failed to prevent pulseless electrical activity...
2016: Ochsner Journal
Kimitoshi Sato, Katsutoshi Abe, Yasuharu Kosaka, Takeshi Ohuchi, Hirotsugu Okamoto, Junya Ako, Toshihiro Kumabe
Coronary vasospasm(CV)can cause severe arrhythmia and myocardial infarction(MI). Intraoperative CV is not limited to cardiac surgery alone. We report the case of a patient who experienced cardiac arrest after the induction of general anesthesia, but did not demonstrate any abnormalities on preoperative examination. The patient was a 60-year-old man with no history of ischemic heart disease, with NASCET 80% asymptomatic left internal carotid stenosis(ICS). We decided to perform carotid endarterectomy(CEA). Preoperative stress myocardial scintigraphy did not reveal decreased local uptake...
July 2016: No Shinkei Geka. Neurological Surgery
David W Barbara, Jon M Christensen, William J Mauermann, Joseph A Dearani, Joseph A Hyder
BACKGROUND: Neuromuscular blockade (NMB) reversal with neostigmine and glycopyrrolate has been reported to cause cardiac arrest in patients with a history of cardiac transplantation. The purpose of this study was to examine the safety of NMB reversal with acetylcholinesterase inhibitors and muscarinic anticholinergics in these patients. METHODS: We queried the medical records of a large tertiary referral center for patients with a history of prior heart transplantation who underwent anesthesia including receipt of NMB reversal...
January 12, 2016: Transplantation
E H A Maas, B M A Pieters, M Van de Velde, S Rex
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is becoming a valuable alternative to surgical aortic valve replacement in patients with severe aortic stenosis that are at high surgical risk or deemed inoperable. The optimal anesthesia technique for TAVI is still undecided. We performed a systematic review and metaanalysis to compare the safety of locoregional anesthesia (LRA) with or without conscious sedation and general anesthesia (GA) for the TAVI-procedure. METHODS: We searched PUBMED, MEDLINE, EMBASE and the Cochrane central register of controlled trials from January 1st 2002 to February 15th 2015...
2016: Current Pharmaceutical Design
Yukako Yoshima, Shota Sonobe, Toshiya Hashimura, Hideki Otada
A 79-year-old man with aortic stenosis (AS) was scheduled for right middle lobectomy under general anesthesia. AS is a significant risk factor for the development of cardiac complications after noncardiac surgery. Anesthetic management adjusting left ventricular preload and coload, and keeping sinus rhythm was successful with no complications. But after moving back to the intensive care unit after surgery, ECG showed paroxysmal complete atrioventricular blocks and we inserted a temporary transvenous pacemaker catheter...
August 2015: Masui. the Japanese Journal of Anesthesiology
Patricia Martín-Hernández, Hugo Gutiérrez-Leonard, José Luis Ojeda-Delgado, Jorge Fagoaga-Valdivia, Rodolfo Barrios-Nanni, Martha Elena Rodríguez-Somarriba, Luis Manuel Páez-Lizárraga, Luis Enrique Berúmen-Domínguez, Lázaro Hernández-Jiménez, Victoria Rebollo-Hurtado, María Del Rocio Blázquez-Cruz
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) is an alternative treatment for patients with severe symptomatic aortic stenosis, inoperable or at high surgical risk. The purpose of this communication is to report the results of the experience of this new technique and compare them with literature. METHODS: Review of 17 patients data with symptomatic severe aortic stenosis at high surgical risk or inoperable, treated with a transcatheter implantation aortic valve (TAVI) via femoral surgical access with Core Valve (Medtronic, EE...
October 2015: Archivos de Cardiología de México
Morgan L Brown, James A DiNardo, Kirsten C Odegard
BACKGROUND: Patients with single ventricle physiology are at increased anesthetic risk when undergoing noncardiac surgery. OBJECTIVE: To review the outcomes of anesthetics for patients with single ventricle physiology undergoing noncardiac surgery. METHODS: This study is a retrospective chart review of all patients who underwent a palliative procedure for single ventricle physiology between January 1, 2007 and January 31, 2014. Anesthetic and surgical records were reviewed for noncardiac operations that required sedation or general anesthesia...
August 2015: Paediatric Anaesthesia
Mee Young Chung, Su Min Chae, Chang Jae Kim
Intracardiac thrombosis is an infrequent and fatal complication in patients with an inserted pacemaker. A patient with an inserted pacemaker scheduled for ureter stone removal experienced cardiac arrest and cardiopulmonary resuscitation under general anesthesia. Echocardiography showed multiple intracardiac thrombi. Preoperative diagnostic workup including echocardiography for the detection of pacemaker lead thrombus, and the need for anticoagulation should be considered in patients with an inserted pacemaker and high-risk factors for thrombosis...
February 2015: Korean Journal of Anesthesiology
Simon D Whyte, Aruna Nathan, Dorothy Myers, Scott C Watkins, Prince J Kannankeril, Susan P Etheridge, Jason Andrade, Kathryn K Collins, Ian H Law, Jason Hayes, Shubhayan Sanatani
BACKGROUND: Patients with long QT syndrome (LQTS) may experience a clinical spectrum of symptoms, ranging from asymptomatic, through presyncope, syncope, and aborted cardiac arrest, to sudden cardiac death. Arrhythmias in LQTS are often precipitated by autonomic changes. This patient population is believed to be at high risk for perioperative arrhythmia, specifically torsades de pointes (TdP), although this perception is largely based on limited literature that predates current anesthetic drugs and standards of perioperative monitoring...
October 2014: Anesthesia and Analgesia
Wei-Han Chou, Yi-Chia Wang, Hsing-Hao Huang, Hsiao-Liang Cheng, Yi-Shiuan Lin, Ming-Jiuh Wang, Chi-Hsiang Huang
OBJECTIVES: Valvular aortic stenosis (AS) is a major cardiac valvular disease in geriatric people. Conventional treatment for severe AS is aortic valve replacement through surgery. However, many geriatric patients are considered inoperable due to higher risks for surgery and anesthesia. Transcatheter aortic valve implantation (TAVI), a less invasive procedure, has rapidly developed in recent years as an alternative management option for high-risk AS patients. Herein, we describe our anesthetic experience in the TAVI procedure...
March 2014: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Amy G Rapsang, Prithwis Bhattacharyya
A pacemaking system consists of an impulse generator and lead or leads to carry the electrical impulse to the patient's heart. Pacemaker and implantable cardioverter defibrillator codes were made to describe the type of pacemaker or implantable cardioverter defibrillator implanted. Indications for pacing and implantable cardioverter defibrillator implantation were given by the American College of Cardiologists. Certain pacemakers have magnet-operated reed switches incorporated; however, magnet application can have serious adverse effects; hence, devices should be considered programmable unless known otherwise...
May 2014: Brazilian Journal of Anesthesiology
Stuart P Thomas, Jay Thakkar, Pramesh Kovoor, Aravinda Thiagalingam, David L Ross
Administration of intravenous sedation (IVS) has become an integral component of procedural cardiac electrophysiology. IVS is employed in diagnostic and ablation procedures for transcutaneous treatment of cardiac arrhythmias, electrical cardioversion of arrhythmias, and the insertion of implantable electronic devices including pacemakers, defibrillators, and loop recorders. Sedation is frequently performed by nursing staff under the supervision of the proceduralist and in the absence of specialist anesthesiologists...
June 2014: Pacing and Clinical Electrophysiology: PACE
J Gayot, A-L Saint-Pol, C Degryse, F Sztark
The number of patients with cardiac pacemaker is continuously increasing. The anesthetic management of these patients is often trivialized, particularly during minor surgery. However there is always a potential risk of dysfunction during anesthesia. Perioperative management of these patients must be careful and standardized to avoid accidents. We report a case of cardiac arrest during general anesthesia for a day-surgery secondary to pacemaker dysfunction by increasing pacing thresholds in a young adult patient...
April 2014: Annales Françaises D'anesthèsie et de Rèanimation
Yoshiko Onodera, Hirotsugu Kanda, Atsushi Kurosawa, Takayuki Kunisawa, Akihiro Suzuki, Osamu Takahata, Hiroshi Iwasaki
We report a case of 30-second cardiac arrest that occurred during carotid body tumor resection due to the carotid sinus reflex. The patient was a 20-year-old man diagnosed with a carotid body tumor and scheduled for tumor resection. General anesthesia was induced and maintained with target controlled infusion of propofol. Analgesia was achieved with continuous administration of remifentanil. When the surgery was initiated, 1% lidocaine 3 ml was locally injected into the carotid bifurcation. When surgery was initiated in the neck region, the patient developed sudden cardiac arrest...
January 2014: Masui. the Japanese Journal of Anesthesiology
Jens Seiler
Bradyarrhythmias are caused by a disturbed impulse formation in the sinus node and/or a disturbed impulse conduction and can be subclassified clinically as sinus node dysfunction, atrioventricular (AV) block, or functional bradycardia. Persistent bradycardia can be diagnosed by standard ECG. For diagnosis of intermittent bradycardia, often long-term ECG monitoring and/or additional testing is necessary. Symptomatic bradycardias are the standard indication for cardiac pacing after exclusion of reversible causes...
February 2014: Therapeutische Umschau. Revue Thérapeutique
Mineto Kamata, Yoh Horimoto
We describe the anesthetic management of a 23-year-old female patient with severe bradycardia due to pacemaker lead disconnection. The pacemaker had been placed due to complete AV block following an extracardiac Fontan operation. She was scheduled for lead repair under general anesthesia. The preoperative HR was only 37 beats x min(-1) of idioventricular rhythm. As further bradycardia was a major concern, we prepared a percutaneous cardiac pacemaker and the catheterization laboratory for transatrial cardiac pacing...
November 2013: Masui. the Japanese Journal of Anesthesiology
Xiao-mei Li, Yan Zhang, Guang-yu Pan, Hai-ju Liu, Hong-yin Li, Qing-yu Wu
OBJECTIVE: To investigate the feasibility, advantages and efficacy of implantation of left atrial and ventricular epicardial dual chamber pacemaker to treat pediatric complete atrioventricular block. METHOD: Eleven children with median age 4.0 years (0.5-7.6 years) diagnosed as complete atrioventricular block resisting to drug therapy received implantations of left atrial and ventricular epicardial dual chamber pacemakers. Six were male and five female. Temporal or permanent right ventricular pacing was used for all of them before implantation of left atrial and ventricular epicardial dual chamber pacemakers...
August 2013: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
T Parveen, F Begum, N Akhter, F Sharmin
Sick sinus syndrome is a generalized abnormality of cardiac impulse formation that may be caused by extrinsic causes or by intrinsic disease of the sinus node making it unable to perform pace making function. It can be manifested for the first time in pregnancy. First case was diagnosed as sick sinus syndrome at 8 weeks of gestation having Mobitz type I heart block (Wenckebach block), and needed temporary pacemaker during caesarean section. Second case was diagnosed at 24 weeks of gestation having complete heart block and needed permanent pacemaker at 38 weeks of gestation due to exaggeration of the symptoms...
April 2013: Mymensingh Medical Journal: MMJ
Eduardo Alonso Garcia, Marco Antonio Campos Machado, João Amaro Ferrari da Silva, Walton Nosé
PURPOSE: To evaluate the nasolacrimal duct reconstitution with radio frequency for restoration of lacrimal flow in cases of nasolacrimal duct obstruction. METHODS: The procedure was carried out in 16 eyes of 16 patients (13 women and 3 men) by the same surgeon, with monopolar high-frequency device at 450 kHz and 150 W, with local anesthesia under sedation. Inclusion criteria were lower lacrimal system obstruction (confirmed by dacryocystogram) and age over 18 years old...
November 2012: Arquivos Brasileiros de Oftalmologia
Kassem Harris, Gregory Maniatis, Faraz Siddiqui, Theodore Maniatis
SESSION TYPE: Miscellaneous Case Report Posters IIPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: We report, to our knowledge, the first case ever describing phrenic nerve injury and unilateral diaphragmatic paralysis following pacemaker pulse generator replacement.CASE PRESENTATION: A 75 year-old woman presented with syncope. She had a permanent pacemaker placed for sinus node dysfunction. Pacemaker interrogation revealed end-of-life battery status, and therefore generator exchange was scheduled...
October 1, 2012: Chest
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