title: Case report: Perioperative pacemaker-mediated tachycardia in the patient with a dual chamber implantable cardioverter-defibrillator.
abstract: Patients with cardiac implantable electronic devices are at additional risk for arrhythmias while undergoing surgical procedures. In this case report, we present a patient with a dual chamber implantable cardioverter-defibrillator who developed intraoperative pacemaker-mediated tachycardia causing significant hemodynamic instability. Management of this arrhythmia can be particularly challenging, because standard application of a magnet does not affect the pacing functions of an implantable cardioverter-defibrillator. Awareness by the anesthesiologist and timely coordination with the cardiac electrophysiology team helped to optimize care for this patient.
authors.affiliation: Department of Anesthesiology, Stony Brook University Medical Center, HSC L-4, Room 060, Stony Brook, NY 11794, USA. Igor.Izrailtyan@stonybrookmedicine.edu
authors.forename: Igor
authors.initials: I
authors.lastname: Izrailtyan
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Schiller
authors.forename: Robert I
authors.initials: RI
authors.lastname: Katz
authors.forename: Ibrahim O
authors.initials: IO
authors.lastname: Almasry
mesh_terms: D000369:Aged, 80 and over; D000768:Anesthesia, General; D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000187:drug effects; D006439:Hemodynamics / Q000502:physiology; D006615:Hip / Q000601:surgery; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D059035:Perioperative Period; D010656:Phenylephrine / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy; D013610:Tachycardia / Q000209:etiology / Q000503:physiopathology*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D010656:Phenylephrine