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Chapter 5 - Defibrillators

Published online by Cambridge University Press:  21 February 2025

Dharti Patel
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Sang J. Kim
Affiliation:
Hospital for Special Surgery, New York
Himani V. Bhatt
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Alopi M. Patel
Affiliation:
Rutgers Robert Wood Johnson Medical School, New Jersey
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Summary

A defibrillator is a device designed to treat ventricular arrhythmias by delivery of an electrical shock that terminates the arrhythmia and restores a normal cardiac rhythm. Defibrillators can be external or internal/implanted (ICD). This chapter reviews the types of defibrillators, with a particular focus on the perioperative management of ICDs. Indications, pad and lead placement, shock therapy, and identification of ICDs are covered.

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Chapter
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BASIC Essentials
A Comprehensive Review for the Anesthesiology BASIC Exam
, pp. 26 - 30
Publisher: Cambridge University Press
Print publication year: 2025

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References

Center for Devices, Radiological Health. Automated External Defibrillators (AEDs). U.S. Food & Drug Administration, 2022. Available from: https://www.fda.gov/medical-devices/cardiovascular-devices/automated-external-defibrillators-aedsGoogle Scholar
ZOLL LifeVest Wearable Defibrillator. Available from: https://lifevest.zoll.comGoogle Scholar
Klein, HU, Goldenberg, I, Moss, AJ. Risk stratification for implantable cardioverter defibrillator therapy: the role of the wearable cardioverter-defibrillator. Eur Heart J 2013 Aug;34(29):22302242.CrossRefGoogle ScholarPubMed
Kutyifa, V, Moss, AJ, Klein, H, et al. Use of the wearable cardioverter defibrillator in high-risk cardiac patients: data from the Perspective Registry of Patients Using the Wearable Cardioverter Defibrillator (WEARIT-II Registry). Circulation 2015 Oct;132(17):16131619.CrossRefGoogle Scholar
Olgin, JE, Pletcher, MJ, Vittinghoff, E, et al. Wearable cardioverter-defibrillator after myocardial infarction. N Engl J Med 2018 Sep 27;379(13):12051215.CrossRefGoogle ScholarPubMed
Masri, A, Altibi, AM, Erqou, S, et al. Wearable cardioverter-defibrillator therapy for the prevention of sudden cardiac death: a systematic review and meta-analysis. JACC Clin Electrophysiol 2019 Feb;5(2):152161.CrossRefGoogle ScholarPubMed
Olgin, JE, Lee, BK, Vittinghoff, E, et al. Impact of wearable cardioverter-defibrillator compliance on outcomes in the VEST trial: as-treated and per-protocol analyses. J Cardiovasc Electrophysiol 2020 May;31(5):10091018.CrossRefGoogle ScholarPubMed
Kamp, NJ, Al-Khatib, SM. The subcutaneous implantable cardioverter-defibrillator in review. Am Heart J 2019 Nov;217:131139.CrossRefGoogle ScholarPubMed
Knops, RE, Olde Nordkamp, LRA, Delnoy, P-PHM, et al. Subcutaneous or transvenous defibrillator therapy. N Engl J Med 2020 Aug 6;383(6):526536.CrossRefGoogle ScholarPubMed
Jacob, S, Shahzad, MA, Maheshwari, R, Panaich, SS, Aravindhakshan, R. Cardiac rhythm device identification algorithm using X-rays: CaRDIA-X. Heart Rhythm 2011 Jun;8(6):915922.CrossRefGoogle ScholarPubMed
Weinreich, M, Weinreich, B, Chudow, J, et al. Computer-aided detection and identification of implanted cardiac devices on chest radiography utilizing deep convolutional neural networks, a form of machine learning. J Am Coll Cardiol 2019 Mar 12;73(9_Supplement_1):307.CrossRefGoogle Scholar
Weinreich, B. Pacemaker-ID. Available from: https://www.pacemakerid.com/Google Scholar
Weinreich, M, Chudow, JJ, Weinreich, B, et al. Development of an artificially intelligent mobile phone application to identify cardiac devices on chest radiography. JACC Clin Electrophysiol 2019 Sep;5(9):10941095.CrossRefGoogle ScholarPubMed
Epstein, AE, DiMarco, JP, Ellenbogen, KA, et al. ACC/AHA/HRS 2008 Guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Col Cardiol 2008;51(21):e162.CrossRefGoogle Scholar
Epstein, AE, DiMarco, JP, Ellenbogen, KA, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2013;61(3):e675.Google Scholar
Russo, AM, Stainback, RF, Bailey, SR, et al. ACCF/HRS/AHA/ASE/HFSA/SCAI/SCCT/SCMR 2013 appropriate use criteria for implantable cardioverter-defibrillators and cardiac resynchronization therapy: a report of the American College of Cardiology Foundation appropriate use criteria task force, Heart Rhythm Society, American Heart Association, American Society of Echocardiography, Heart Failure Society of America, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic resonance. Heart Rhythm 2013 Apr;10(4):e1158.CrossRefGoogle Scholar
Kusumoto, FM, Calkins, H, Boehmer, J, et al. HRS/ACC/AHA expert consensus statement on the use of implantable cardioverter-defibrillator therapy in patients who are not included or not well represented in clinical trials. Circulation 2014 Jul 1;130(1):94125.CrossRefGoogle ScholarPubMed
Link, MS, Atkins, DL, Passman, RS, et al. Part 6: electrical therapies: automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010 Oct;122(18_suppl_3):S706S719.CrossRefGoogle ScholarPubMed
Samson, RA, Berg, RA, Bingham, R, et al. Use of automated external defibrillators for children: an update: an advisory statement from the pediatric advanced life support task force, International Liaison Committee on Resuscitation. Circulation 2003;107(25):32503255.CrossRefGoogle ScholarPubMed
Atkins, DL, Jorgenson, DB. Attenuated pediatric electrode pads for automated external defibrillator use in children. Resuscitation 2005 Jul;66(1):3137.CrossRefGoogle ScholarPubMed
Atkins, DL, Scott, WA, Blaufox, AD, et al. Sensitivity and specificity of an automated external defibrillator algorithm designed for pediatric patients. Resuscitation 2008 Feb;76(2):168174.CrossRefGoogle ScholarPubMed
Panchal, AR, Bartos, JA, Cabañas, JG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020 Oct 20;142(16_suppl_2):S366S468.CrossRefGoogle ScholarPubMed
Botto, GL, Politi, A, Bonini, W, Broffoni, T, Bonatti, R. External cardioversion of atrial fibrillation: role of paddle position on technical efficacy and energy requirements. Heart 1999 Dec;82(6):726730.CrossRefGoogle ScholarPubMed
Ambler, JJS, Sado, DM, Zideman, DA, Deakin, CD. The incidence and severity of cutaneous burns following external DC cardioversion. Resuscitation 2004 Jun;61(3):281288.CrossRefGoogle ScholarPubMed
Lüker, J, Sultan, A, Plenge, T, et al. Electrical cardioversion of patients with implanted pacemaker or cardioverter-defibrillator: results of a survey of German centers and systematic review of the literature. Clin Res Cardiol 2018 Mar;107(3):249258.CrossRefGoogle ScholarPubMed
Heart Rhythm Society. 2011 HRS/ASA Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers, and Arrhythmia Monitors: Facilities and Patient Management. 2011. Available from: https://www.hrsonline.org/guidance/clinical-resources/2011-expert-consensus-statement-perioperative-management-patients-implantable-defibrillatorsGoogle Scholar
Crossley, GH, Poole, JE, Rozner, MA, et al. The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors: Facilities and Patient Management. Heart Rhythm 2011 Jul;8(7):11141154.CrossRefGoogle ScholarPubMed
Stone, ME, Salter, B, Fischer, A. Perioperative management of patients with cardiac implantable electronic devices. Br J Anaesth 2011 Dec;107(Suppl):i1626.CrossRefGoogle ScholarPubMed
Izrailtyan, I, Schiller, RJ, Katz, RI, Almasry, IO. Perioperative pacemaker-mediated tachycardia in the patient with a dual chamber implantable cardioverter-defibrillator. Anesth Analg 2013 Feb;116(2):307.CrossRefGoogle ScholarPubMed
Thompson, A, Neelankavil, JP, Mahajan, A. perioperative management of cardiovascular implantable electronic devices (CIEDs). Curr Anesthesiol Rep 2013 Sep 1;3(3):139143.CrossRefGoogle Scholar
Williams, MR, Atkinson, DB, Bezzerides, VJ, et al. Pausing with the gauze: inhibition of temporary pacemakers by radiofrequency scan during cardiac surgery. Anesth Analg 2016 Nov;123(5):11431148.CrossRefGoogle ScholarPubMed
Richman, T, Stanton, T, Fryer, M, Dayananda, N, Tung, M. Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants. Pacing Clin Electrophysiol 2023 Oct 21;46(2):9399.CrossRefGoogle ScholarPubMed
Russo, RJ, Costa, HS, Silva, PD, et al. Assessing the risks associated with MRI in patients with a pacemaker or defibrillator. N Engl J Med 2017 Feb;376(8):755764.CrossRefGoogle ScholarPubMed
Bhuva, A, Charles-Edwards, G, Ashmore, J, et al. Joint British Society consensus recommendations for magnetic resonance imaging for patients with cardiac implantable electronic devices. Heart 2024;110(4):e3.CrossRefGoogle ScholarPubMed

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  • Defibrillators
  • Edited by Dharti Patel, Mount Sinai West and Morningside Hospitals, New York, Sang J. Kim, Hospital for Special Surgery, New York, Himani V. Bhatt, Mount Sinai West and Morningside Hospitals, New York, Alopi M. Patel, Rutgers Robert Wood Johnson Medical School, New Jersey
  • Book: BASIC Essentials
  • Online publication: 21 February 2025
  • Chapter DOI: https://doi.org/10.1017/9781009334792.006
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  • Defibrillators
  • Edited by Dharti Patel, Mount Sinai West and Morningside Hospitals, New York, Sang J. Kim, Hospital for Special Surgery, New York, Himani V. Bhatt, Mount Sinai West and Morningside Hospitals, New York, Alopi M. Patel, Rutgers Robert Wood Johnson Medical School, New Jersey
  • Book: BASIC Essentials
  • Online publication: 21 February 2025
  • Chapter DOI: https://doi.org/10.1017/9781009334792.006
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Defibrillators
  • Edited by Dharti Patel, Mount Sinai West and Morningside Hospitals, New York, Sang J. Kim, Hospital for Special Surgery, New York, Himani V. Bhatt, Mount Sinai West and Morningside Hospitals, New York, Alopi M. Patel, Rutgers Robert Wood Johnson Medical School, New Jersey
  • Book: BASIC Essentials
  • Online publication: 21 February 2025
  • Chapter DOI: https://doi.org/10.1017/9781009334792.006
Available formats
×