This user manual is intended as a perioperative guide for anesthesiologists which deals with the interrogation and management of Boston Scientific’s Cardiovascular Implantable Electronic Devices (CIEDs), particularly focusing on the cardiac resynchronization therapy device with defibrillator capabilities (CRT-D) and the subcutaneous implantable cardioverter defibrillator (S-ICD).
The document serves an educational purpose, aiming to increase anesthesiologists’ familiarity with Boston Scientific CIEDs and their management during the perioperative period. The manual underlines that it is not advocating for untrained professionals to perform elect interrogation and programming of CIEDs, rather it is a call for anesthesiologists to seek proper training and education. It is presented as a supplementary resource to other existing literature on CIED management.
Boston Scientific’s CIEDs have broad applications across a range of conditions, offering varying levels of pacing support and defibrillator protection. The manual outlines indications for CIED implantation, including sinus node dysfunction, acquired atrioventricular block, chronic bifascicular block, hypersensitive carotid sinus syndrome, neurocardiogenic syncope, and post-acute myocardial infarction scenarios. CRT specifically attends to patients with reduced ejection fraction and widened QRS complexes, aiming to improve cardiac output and related symptoms by ensuring synchronized left ventricular contractions.
While ICDs, including CRT-D devices, come with pacing functionality, they also serve to avert cardiac death either as a primary or secondary measure. The manual sheds light on the S-ICD, noting its distinct capabilities in the context of perioperative management challenges and necessary programming adjustments.
The guide includes references to further Boston Scientific review articles and emphasizes the importance of education in managing CIEDs for anesthesiologists. Although only the first two pages of the manual are analyzed, it is clear that it aims to enhance the understanding and practical knowledge of operating and managing Boston Scientific CIEDs within the scope of anesthesiology.
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