Do Patients with Asymptomatic Congenital Complete Heart Block Require a Pacemaker for Non-Cardiac Surgery?

• 作者: Barry Swerdlow
• 来源期刊: 麻醉学期刊(英文)
• 学科: 医学
• 关键词: CONGENITAL COMPLETE HEART Block PACEMAKER NON-CARDIAC Surgery
• 年，卷（期）: 2018,（4）
• 页码范围: 130-135
• 页数: 6页
• 分类号: R5

摘要

The appropriate preparation of the patient with asymptomatic congenital complete heart block (CCHB) and a narrow QRS complex for elective non-cardiac surgery is controversial. Prophylactic temporary pacemaker insertion is associated with well-defined risks, and less invasive techniques exist to treat transient, hemodynamically significant intraoperative brady-arrhythmias. The present case report details the performance of general anesthesia for arthroscopic knee surgery in an adult patient with this condition without a pacemaker. Documentation of preoperative chronotropic competence with isoproterenol may be of value in deciding whether to proceed without temporary pacing capability in this setting.