RT Book, Section
A1 Spotnitz, Henry M.
A2 Cohn, Lawrence H.
SR Print(0)
ID 55928033
T1 Chapter 59. Surgical Implantation of Pacemakers and Automatic Defibrillators
T2 Cardiac Surgery in the Adult, 4e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163310-9
LK accesssurgery.mhmedical.com/content.aspx?aid=55928033
RD 2024/04/25
AB Pacemaker  and  defibrillator  management  is  the  subject  of  comprehensive  reviews.1  In  the  author's  experience  with  2760  procedures,  23%  of  pacemaker  recipients  and  5%  of  implantable  cardioverter  defibrillator  (ICD)  recipients  were  octogenarians.  The  incidence  of  pacemaker  insertion  in  patients  older  than  75  was  2.6%  in  a  recent  survey.  The  efficacy  and  cost-effectiveness  of  pacemakers  are  widely  accepted,  but  the  appropriate  role  for  ICD  insertion  and  biventricular  pacing  in  older  patients  is  still  in  evolution.  Pacemaker  and  ICD  technology  is  now  applicable  across  the  entire  span  of  human  age,  with  pacing  for  heart  failure  and  ICD  prophylaxis  against  lethal  arrhythmias  recent  frontiers.  Electrophysiologists  now  dominate  these  areas,  reflecting  decreased  interest  by  thoracic  surgeons  and  cardiology  referrals.  However,  thoracic  surgeons  must  maintain  skills  as  implanters  and  consultants  for  complex  or  complicated  cases.  This  chapter  reviews  practical  information  related  to  pacemaker  and  ICD  insertion  and  management.