APPENDIX 1: Preanesthesia Pulse Generator Evaluation

Determining the indication for and date of initial device placement

Determining the patient's underlying rhythm and rate (if any)

Identifying the number and types of leads

Determining the last generator test date and battery status

Obtaining a history of generator events (if any)

Obtaining the current program information (device interrogation), including mode, rate, and rate enhancements

Ensuring that generator discharges become mechanical systoles with adequate pacing safety margins

Ensuring adequate safety margin for sensing events (if intrinsic events are present)

Ensuring that magnet detection is enabled (magnet behavior and rate should be recorded) if magnet use is indicated

Determining whether the pacemaker should be reprogrammed, which depends upon pacemaker dependency, surgery type and location, need for increased heart rate, etc.

The preanesthetic pacemaker evaluation should consist of a device interrogation. The statements, above, can be fashioned into a request to the cardiologist or pacemaker service. Note that for ICDs, the term "generator events" includes a history of antitachycardia therapy