nanci
Junior Member
Posts: 57
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Post by nanci on Feb 28, 2020 11:08:16 GMT -5
1. From your experience, what pacemaker information will you be looking for if your patient with a pacemaker is coming in for surgery? What type of device does the patient have (Manufacturers ID card, CXR, Cardiology consultation), How is the device programmed (mode, lower and upper rates, rate-responsiveness, unipolar or bipolar sensing, is the device programmed to respond to a magnet), Is the patient device dependent, how likely is there to be electromagnetic interference (EMI) during the procedure.
2. What are the 2 leadless pacemaker systems that are currently available? And how can they be switched to asynchronous mode intraoperatively if needed? Micra Transcatheter Pacer System (TPS)would need to be reprogrammed and the Nanostim leadless cardiac pacemaker which has the capacity to be programmed for magnet on or magnet off.
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Post by angie brooks on Feb 28, 2020 11:49:27 GMT -5
1. From your experience, what pacemaker information will you be looking for if your patient with a pacemaker is coming in for surgery? I look at the type of pacer and if there is an AICD component. I want to know if it has recently been interrogated to determine if it is functioning properly especially if the patient is completely pacer dependent without an underlying rhythm that is able to perfuse the system. 2. What are the 2 leadless pacemaker systems that are currently available? And how can they be switched to asynchronous mode intraoperatively if needed? Micra transcatheter pacer (Medtronic) has to be reprogrammed to asynchronous mode. It will not respond to a magnet. Nanostim (Abott) can be changed to asynchronous mode by placing magnet over pacemaker site.
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Post by Vania Milnes on Feb 28, 2020 12:06:01 GMT -5
1. From your experience, what pacemaker information will you be looking for if your patient with a pacemaker is coming in for surgery?
I like to know when it was last interrogated, what mode, are they pacer dependent, and where on the body is the surgery going to be... How close to the pacemaker?
2. What are the 2 leadless pacemaker systems that are currently available? And how can they be switched to asynchronous mode intraoperatively if needed?
Micra (requires reprogramming) and Nanostim (can use a magnet)
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Post by Jessica Switzman on Feb 29, 2020 7:50:43 GMT -5
Thank you for this interesting article on leadless pacers. When my patient has a pacer I want to know what type, is it an AICD, are they fully pacer dependent. what is their underlying rhythm and when was last interrogated.
According to the article there are two leadless pacers currently available: Nanostim that is responsible to magnet and Micra that must be programmed into asynchronous mode.
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Post by Katya on Feb 29, 2020 13:59:03 GMT -5
1. I usually look for whether the pacemaker has an AICD option , the mode of function is, and whether the patient is pacemaker dependent. I also consider the type of surgery and likelihood that there may be EMI during the procedure. I also check when the device was last interrogated and if they did any change in settings.
2. The two leadless pacemakers currently available are: A. Micra transcatheter pacing system (Medtronic):This device needs to be reprogrammed to asynchronous and will not respond to placement of a magnet. B. Nanostim (Abott): This device can be changed to asynchronous mode by placing magnets over pacemaker site.
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Post by BGardner on Feb 29, 2020 16:37:44 GMT -5
1. As noted above, most important would be to know manufacturer, settings, underlying rhythm and should be interrogated within the last 30days. This should be done prior to every anesthetic and can usually be found in Media in EPIC for our patients. 2.Leadless pacemakers currently available include Nanostim which can be switched to asynchronous mode with magnet and Micra which need to be reprogrammed. Nice review on cautery types, distance and precautions.
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Post by Amy Schutter on Feb 29, 2020 18:18:05 GMT -5
1. Patients coming for surgery with a pacemaker I question, manufacturer of pacer, last interrogated, whether its an AICD, if they are pacer dependent and underlying rhythm. I consider location of surgery as well. 2. The two types on headless pacemakers are the Nanostim (able to be converted to asynchronous mode with the application of magnet) and the Micra Transcatheter this pacer must be reprogrammed in order to be switched to asynchronous mode, this device is not responsive to the magnet.
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Post by Lu Lin on Feb 29, 2020 22:11:27 GMT -5
I would like to know the type of device, wether the patient is pacer-dependent or not, if the device is functioning properly, and whether electromagnetic interference(EMI) is expected in the planned procedure. And if magnet is used, what management do afterwards.
Currently, 2 devices are available in the United States: the Micra Transcatheter Pacing System (TPS) and the Nanostim leadless cardiac pacemaker. Magnet response is an important consideration in both conventional pacemakers and LPs.
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