SUMMARY
Electronic miniaturization has permitted the design and use of
sophisticated electronics in patients who have need for artificial pacing and/or
automated cardioversion/defibrillation of their heart. These devices are no longer
confined to merely keeping the heart beating between a minimum rate (pacing function)
and a maximum rate (ICD functions), as they are now being used as therapy to improve
the failing heart.
The aging of the population and our ability to care for a patient
with increasingly complex disease suggest that we will be caring for many more patients
with these devices, and we must be prepared for this situation. Safe and efficient
clinical management of these patients depends upon our understanding of implantable
systems, indications for their use, and the perioperative needs that they create.