Inappropriate Firing Of Implantable Cardioverter-defibrillator In An Emergent Craniectomy
An 80yo male with ischemic cardiomyopathy and implantable cardiac device presented to the OR for craniectomy and surgical evacuation of bilateral subdural hematomas. Due to the emergent nature of the situation, his device settings and his dependency were unable to be confirmed prior to induction. Despite placing a magnet on the device, it fired twice with initial use of electrocautery. The anesthesiologist replaced the magnet and the case proceeded uneventfully. We will discuss guidelines for AICD/pacemaker interrogation, intraoperative management, and troubleshooting of such devices.
Burandt D, Banooni A. Inappropriate firing of implantable cardioverter-defibrillator in an emergent craniectomy. Abstract presented at: Anesthesiology 2019. American Society of Anesthesiology, Orlando, FL; 2019 October 19-23.