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The perioperative management of small animals with previously implanted pacemakers undergoing anaesthesia

  • Alejandra García de Carellán Mateo
    Correspondence
    Correspondence: Alejandra García de Carellán Mateo, Teaching Veterinary Hospital, Catholic University of Valencia, Av. Pérez Galdós 51, Valencia 46018, Spain.
    Affiliations
    Anaesthesia and Analgesia Service, Teaching Veterinary Hospital, Department of Animal Medicine and Surgery, School of Veterinary Science, Catholic University of Valencia, Valencia, Spain
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  • Domingo Casamián-Sorrosal
    Affiliations
    Cardiology and Interventional Cardiology Service, Teaching Veterinary Hospital, Department of Animal Medicine and Surgery, School of Veterinary Science, Catholic University of Valencia, Valencia, Spain
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Published:November 21, 2021DOI:https://doi.org/10.1016/j.vaa.2021.05.007

      Abstract

      Objective

      There is little information in the veterinary literature about the perioperative management of small animal patients with previously implanted pacemakers undergoing elective or emergency non-cardiac procedures. The purpose of this article is to review the current literature with regard to human patients, with previously implanted pacemakers, undergoing general anaesthesia. Using this and the current information on pacemakers and anaesthesia in dogs and cats, we provide recommendations for small animal patients in this situation.

      Databases used

      Google Scholar, PubMed and CAB Abstracts using and interlinking and narrowing the search terms: “dog”, “cat”, “small animals”, “anaesthesia”, “pacemaker”, “perioperative”, “transvenous pacing”, “temporary pacing”. Scientific reports and human and small animal studies from the reference lists of the retrieved papers were reviewed. In addition, related human and veterinary cardiology and anaesthesia textbooks were also included to create a narrative review of the subject.

      Conclusions

      The best perioperative care for these animals comes from a multidisciplinary approach involving the anaesthetist, cardiologist, surgeon and intensive care unit team. When such an approach is not feasible, the anaesthetist should be familiar with pacemaker technology and how to avoid perioperative complications such as electromagnetic interference, lead damage and reprogramming of the device. The preanaesthetic assessment should be thorough. Information regarding the indication for pacemaker placement, complications during the procedure, location, type and programming of the pacemaker should be readily available. The anaesthetic management of these veterinary patients aims to preserve cardiovascular function while avoiding hypotension, and backup pacing should be available during the perioperative period. Further prospective studies are needed to describe the best perioperative care in small animals with a previously implanted pacemaker.

      Keywords

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