Safety and outcomes of noncardiac surgery in patients with cardiac implantable electronic devices

Abstract

Background: Electromagnetic interference can cause damage to cardiac implantable electronic devices (CIEDs). The current guidelines recommend the interrogation of all pacemakers and defibrillators before and after surgery. The objective of the study was to evaluate the safety and outcomes of noncardiac surgeries in patients with CIEDs. Methods: Between January 2014 and January 2019, all patients with CIEDs who underwent noncardiac surgery were included. The patient's baseline characteristics and data regarding their procedure and postsurgical complications and mortality were extracted from their medical records. The device analysis 6 months after the procedure was also seen. Results: Of the 54 patients, 16 had permanent pacemaker, 25 implantable cardioverter defibrillator, and 13 cardiac resynchronization therapy device. Most common indication for surgery was inguinal or abdominal hernia (n = 46); three patients underwent surgery for cholecystitis and five for other reasons. Supraventricular tachycardia was reported in one patient during surgery and in another one after surgery. Only one patient experienced intraoperative ventricular tachycardia. There was no device malfunction during and after surgery. During 6-month follow-up, 5.6% mortality rate was reported. Conclusions: With recommended device programming before surgery, noncardiac surgery is well tolerated in the majority of the patients with CIEDs without significant interference in the device function.

Keywords

• implantable cardiac devices
• malfunction
• noncardiac surgery
• safety