J Thorac Dis. 2026 May 31;18(5):536. doi: 10.21037/jtd-2026-1-0434. Epub 2026 May 27.
ABSTRACT
BACKGROUND AND OBJECTIVE: Cardiac implantable electronic devices (CIEDs) offer lifesaving treatment in patients with significant bradycardia or who at risk for malignant arrhythmias. As the implantation and sophistication of these devices continue to increase, it is imperative for perioperative clinicians to be knowledgeable in their management. While societies have produced documents for guidance, they differ in some recommendations. Furthermore, many societies have released updated or new guidance within the last several years. This review aims to summarize the latest types of CIEDs and perioperative management recommendations.
METHODS: A search in PubMed was performed with a focus on locating guidelines, consensus statements, and practice advisories from major national and international organizations from January 2020 to September 2025. Secondary searches were subsequently conducted based on the content of the initial papers. Only papers in the English language were considered.
KEY CONTENT AND FINDINGS: Five guidance documents were retrieved based on the search. Some had endorsement from numerous groups, but notable organizations included: (I) the American Society of Anesthesiologists (ASA); (II) European Heart Rhythm Association (EHRA)/Heart Rhythm Society; (III) British Heart Rhythm Society; (IV) American Heart Association (AHA)/American College of Cardiology (ACC); and (V) AHA.
CONCLUSIONS: Familiarity with these devices and how to manage them perioperatively is necessary to safely care for these patients in the perioperative period. Although there are similarities between perioperative management strategies, differences exist between recommendations from various societies. Furthermore, the scope of each of these documents differs, with some being more detailed and others lacking details. In the absence of a universal protocol, clinicians could benefit from being familiar with guidance from each of these organizations, taking into consideration the strengths and limitations of the documents, and applying the recommendation that is most relevant and specific to their patient.
PMID:42306726 | PMC:PMC13266869 | DOI:10.21037/jtd-2026-1-0434