心脏植入型电子器械患者的围手术期管理

Perioperative management of patients with cardiac implantable electronic devices

背景 心脏植入型电子器械（cardiac implantable electronic devices,CIEDs）包括起搏器、植入型心律转复除颤器（implantable cardioverter defibrillators,ICDs）和心脏再同步治疗（cardiac resynchronization therapy,CRT）装置.目前中国每年安装ICDs 2 000多台、CRT装置约为2 200台,每年每百万人口安装心脏起搏器38台. 目的 帮助麻醉医师掌握CIEDs患者的围手术期管理技术. 内容 回顾CIEDs患者的围手术期管理. 趋向 CIEDs患者可能需要接受外科手术或胃肠镜等微创手术.围手术期CIEDs患者管理情况比较复杂,迄今为止也很少有关于围手术期CIEDs管理的指南.

Background Cardiac implantable electronic devices （CIEDs） include pacemakers,implantable cardioverter defibrillators （ICDs） and cardiac resynchronization therapy （CRT）.At present,the number of installed ICDs in China annually is more than 2 000 and the CRT device is about 2 200.There are 38 per million people receiving heart pacemakers.Objective The anesthesiologist should know the perioperative management of patients with cardiac implantable electronic devices.Content In this article,we reviewed the perioperative management of patients with CIEDs.We hope to help the anesthesiologists.Trend Such patients with CIEDs may also need to accept the surgical operation or gastrointestinal endoscopy or other minimally invasive surgery.The management of patients with electronic devices in perioperative period is very complicated.Continuing education has not kept pace with.So far,there are few guidelines on the management of CIEDs.