- Try to get the cardiologist to come in and interrogate the pacer and program it if necessary.
- Not likely to happen at night.
- Try to find out about the pacer from the patient, family, medical records.
- Does the patient have his/her pacemaker card?
- Call the manufacturer (phone numbers below) of the specific pacemaker (name and dob, if no pacer card or other information).
- Why was it put in?
- What kind is it?
- When was the battery changed?
- What is the patient’s underlying rhythm?
- What will application of a magnet do?
- Armed with this information, get the cardiologist’s opinion on how to manage the patient.
- If it is an ICD, then definitely get a cardiologist to recommend management.
- experts agree that antitachyarrhythmia functions should be suspended
- advise the surgeon to use a bipolar electrocautery system or harmonic scalpel to minimize adverse effects of EMI (electromechanical interference)
- Have the magnet handy.
- Have temporary pacing and defibrillator equipment available.
- Medtronic 800-505-4636
- BostonScientific 800-227-3422
- St.Jude 800-722-3774
- Biotronic 800-547-0394
- A magnet correctly applied to a pacemaker often results in asynchronous pacemaker function at a predetermined rate without rate responsiveness.
- The magnet rate and response vary by manufacturer.
- Magnet response can be affected by programming and remaining battery life.
- The magnet rate may be excessive for some patients.
- Some pacemakers may have no magnet response.
- Magnet application to an ICD rarely alters bradycardia pacing rate and function.
- A magnet correctly applied to an ICD often results in suspension of tachyarrhythmia therapy.
- For most ICDs, there is no reliable means to detect appropriate magnet placement.
- Some ICDs may have no magnet response.
- Some ICDs can be permanently disabled by magnet application.
#Taken from the American Society of Anesthesiologist’s Guidelines:
Practice Advisory for the Perioperative Management of Patients with Cardiac Implantable Electronic Devices: Pacemakers and Implantable Cardioverter-Defibrillators
An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Cardiac Implantable Electronic Devices