Abstract

Cardiac pacemakers and implantable cardioverter-defibrillators have revolutionized the treatment of patients with cardiac arrhythmias. Since implantation of the first pacemaker in 1958, cardiac device therapy has seen a steady expansion. This is mainly attributable to phenomenal progress in device technology and software sophistication. Recent data from landmark trials suggest that the indications for cardiac pacing and implantable defibrillators are set to expand further, to include, for example, heart failure, sleep disordered breathing and perhaps even routine defibrillator implantation in patients with myocardial infarction and poor ventricular function. This will inevitably result in more patients with cardiac devices being encountered by medical practitioners other than cardiologists. This article reviews the basic principles of device nomenclature, function and physiology for pacemakers and defibrillators commonly encountered in surgical patients who may require anaesthesia.

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