Bhatia Meena, Safavi-Naeini Payam, Razavi Mehdi, Collard Charles D, Tolpin Daniel A, Anton James M
1 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
2 Texas Heart Institute, Houston, TX, USA.
Semin Cardiothorac Vasc Anesth. 2017 Dec;21(4):302-311. doi: 10.1177/1089253217728581. Epub 2017 Sep 21.
Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death. Traditionally, CIEDs have been reliant on the use of transvenous endocardial leads to directly connect with the heart. Over time, these endovascular leads may become endothelialized rendering removal extremely difficult. As the indications for CIEDs expands and with the continuing evolution of these devices, the number of patients requiring explantation for device recall, malfunction, and infection continues to increase. In this manuscript, we review the most common CIEDs, the indications and process of lead removal/device explantation, potential complications associated with the procedure and the anesthetic management of these patients.
心血管植入式电子设备（CIEDs）在现代心血管疾病管理中发挥着重要作用。CIEDs包括植入式起搏器（PMs）、植入式心脏复律除颤器（ICDs）和心脏再同步治疗（CRT）设备。这些设备改善了接受者的生活质量，并有助于降低心源性猝死的发生率。传统上，CIEDs一直依赖使用经静脉心内膜导线直接与心脏相连。随着时间的推移，这些血管内导线可能会发生内皮化，导致移除极其困难。随着CIEDs适应症的扩大以及这些设备的不断发展，因设备召回、故障和感染而需要进行移除植入物手术的患者数量持续增加。在本手稿中，我们回顾了最常见的CIEDs、导线移除/设备取出的适应症和过程、与该手术相关的潜在并发症以及这些患者的麻醉管理。
