Inadequate Pacemaker Checkups Risky for Surgery Patients

A study has found that a surprising number of pacemaker patients undergoing surgery have not had regular checkups of their devices, putting them at risk for cardiac complications during and after the surgery.

The retrospective study involved 159 pacemaker patients between January 2000 and October 2001. Researchers found that 42% had not had the appropriate telephone checkups and 32% had not received the recommended annual comprehensive in-office evaluation.

"The operating room is not a hospitable place for pacemakers,” said Marc A. Rozner, Ph.D., M.D., anesthesiologist and associate professor of cardiology at M.D. Anderson Cancer Center at the University of Texas (Houston, USA; www.mdanderson.org) and principal author of the study. As an example, he explained that surgery performed with electrocautery can disrupt normal pacemaker functioning. Also, pacemaker problems that have gone unnoticed by patients who have not received appropriate follow-up care can grow into potentially serious heart-beat irregularities during and after surgery.

In addition, as pacemakers age, they enter an "intensified follow-up interval” that requires more frequent telephone checkups. Of the patients seen at the clinic during this special period, more than 72% has not received a telephone checkup and 49% had not received an in-office evaluation prior to surgery. In fact, in the study, 15% of pacemaker patients required intervention before surgery to remedy problems with their devices.

Pacemakers contain electronic components that record the patient's history of checkups, and doctors can access this information by computer during preoperative evaluations. "Our study suggests that anesthesiologists should make documentation of pacemaker care a routine component of assessments before and after surgery,” noted Dr. Rozner.




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