Perioperative Considerations in patients with Cardiac Implantable Electronic Devices

The care of patients with CIEDs during perioperative period poses unique challenges to ensure a high degree of patient safety. Currently, there are no randomized controlled trials in this area; therefore, many of the recommendations are based upon the observational studies and expert consensus. Regarding to continuing evolution in CIEDs technology, there are no simple rules to manage them perioperatively. Also, creation of a uni perioperative care algorithm for the patients with CIEDs is complicated by the diversity of devices which currently is manufactured by the different companies. The purpose of this document is to provide a general approach in management of these Patients perioperatively which is based upon the reviewing articles and use expert advisories have been developed by some well-known international societies such as HRS (heart rhythm society), ASA (American society of anesthesiology), STS(the society of thoracic surgeons) and etc ... It is intended to provide guidance to the health care professionals who care for patients with CIEDs during perioperative period and Its important to remember that there are no absolutes with regard to many clinical situations and the ultimate judegement regarding care of a particular patient must be made by the physician in light of all the circumstances presented by the patient and procedure type. The topic discusses the potential problems that can occur in these patients during the perioperative setting and gives some recommendations for the appropriate evaluation and management of the CIEDs during the procedure and postoperative care.